No abstract available.
Adenocarcinoma* ; Rectum*

No abstract available.
Dermatitis, Allergic Contact* ; Fusidic Acid* ; Sodium*

In a conservative treatment of lumbar disc herniation, authors customarily had included the flexion exercise untill 1991. Thereafter, the extension exercise started to be included for the selected patients and this study was designed to assess the clinical outcome of the extension exercise compared to the flexion exercise in the conservative treatments of lumbar disc herniations. 55 consecutive patients (31 males and 24 females having ages ranging from 19-68 years with a mean of 37.2) were included in this prospective study. Criteria for inclusion in this group were: 1. Contained herniations of a single lumbar disc, documented by CT or MRI; 2. no other concurrent spine pathology; 3. conservative treatments with an uniform program including the extension exercise; 4. follow-up for a minimum of one year. For comparison with this prospective group, another 62 consecutive patients (36 males and 26 females having ages ranging from 17-63 years with a mean of 35.7) were selected who were treated during 1991 with flexion exercise before this study was designed and who were matched with the designed criteria except for the direction of exercise. Apart from the therapeutic exercise, the conservative treatments also included medication, physiotheraphy, epidural injection, and back school in the both groups uniformly. The clinical outcome of the extension exercise group indicated that 28 (50.9%) patients excellent, 23 (41.8%) patients good, three (5.5%) patients fair, and one (1.8%) patient failed outcomes. In the flexion exercise group, there were 23 (37.1%) excellent, 27 (43.5%) good, seven (11.3%) fair, and five (8.1%) failed outcomes. From these results, it would seem to follow that the extension exercise group had superior clinical outcome compared to the flexion exercise, i.e. higher excellent and good outcomes (92.7% vs. 80.6%) and lower poor and failed outcomes (7.3% vs. 19.4%), respectively, Moreover, the excellent outcome in terms of full recovery without any pain and disability was more common in the extension exercise group (50.9% vs. 37.1%). A better clinical outcome was obtained in the extension exercise group of patients who were younger than 40 years and who had a history of three months or less compared with those who were older and had longer history of disease. The sizes of disc protrusion did not affect the clinical outcome. In conclusion, we would recommend that the extension exercise, instead of the flexion exercise, should be included in the conservative treatment of a contained herniation of lumbar disc for a better clinical outcome.
Female ; Follow-Up Studies ; Humans ; Injections, Epidural ; Magnetic Resonance Imaging ; Male ; Pathology ; Prospective Studies ; Spine

The primary aims of fracture treatment include the restoration of normal anatomy and a return of function to the injuried as early as possible. In pilon fracture, various methods of treatment were developed to accomplish this purpose. Fibular fixstion is a rarely accepted mehtod in the treatment of pilon fractures because it can't provide rigid internal fixation, But it might be indicated when an open wound was : present medially over the distal tibia, the ligamentous attachments of distal fibula and medial malleolus to talus and calcaneus and of the distal tibiofibular syndesmosis are largely intict. Utilizing these attachment, Fibular fixation can stabilize comminuted fractures of distal tibia affecting ankle joint. This procedure is so effective and simple The author has used this technique in three instances for two years with excellent results. This is not an original method, but worthy of being remindful of the literature.
Ankle Joint ; Ankle ; Calcaneus ; Fibula ; Fractures, Comminuted ; Ligaments ; Methods ; Talus ; Tibia ; Tibial Fractures ; Wounds and Injuries

PURPOSE: In spite of many published reports about the primary gastrointcstinal lymphoma in Korea, the majority of them unfortunately involved a small number of patients with diverse results conceming treatment, patient survival, and prognostic factors. There also were few reports mainly focusing on primary intestinal lymphoma alone. Therefore we studied the patient-survival and prognostic factors in 52 cases of intestinal lymphomas. MATERIALS AND METHODS: We reviewed fifty two patients who received treatment due to primary intestinal lymphoma at Severance hospital, from January 1980 to June 1995. RESULTS: The intestinal lymphomas were located in descending order of frequency at the terminal ileum, i1eocecal region, right colon, and the jejunum. The most common histologic type was diffuse large cell type and the majority showed an intermediate grade of differentiation. The average survival time was 40.7 months with a 5 year survival rate of 41.4%. The overall and complete remission rate of the intestinal lymphoma were 76.2%, 64.3%, respectively. Additional chemotherapy or radiotherapy to surgery improved remission rate. The overall 5 year survival rates were 50.4%, 47.3%, 33.3%, and 25.0% in stage I, II1, II2 and III~IV, respectively. The 5 year survival rate after curative resection was 57.0% and 16.6% after incomplete resection. The significant prognostic factors were residual tumor, site of the lesion, multiplicity, and adjacent organ invasion. However, the site of the lesion alone (worst in the jejunum) was the sole independent variable on multivariate analysis. CONCLUSION: We concluded that early diagnosis and curative resection were important to improve survival rates in the primary intestinal lymphoma. More number of such cases are needed for further comparison of various treatment methods and results.
Colon ; Drug Therapy ; Early Diagnosis ; Humans ; Ileum ; Jejunum ; Korea ; Lymphoma* ; Multivariate Analysis ; Neoplasm, Residual ; Radiotherapy ; Survival Rate

BACKGROUND: Gastric cancer that occurs 5 or more years after a partial gastric resection for benign disease is defined as gastric remnant cancer. The purpose of this study was to examine the clinicopathologic features and the treatment results of sixteen cases of gastric remnant cancer following partial gastrectomies for benign gastroduodenal diseases. METHODS: Sixteen patients who underwent operations for gastric cancer in the remnant stomach from January 1980 to December 1996 were evaluated retrospectively. RESULTS: The mean age was 51.5 years, and 15 patients were male. All of them had undergone surgical treatment for benign disorders, including gastric ulcers (14 cases) and duodenal ulcers (2 cases), and the mean time interval between the primary operation and the diagnosis of gastric cancer was 24.5 years. Most patients presented vague, nonspecific symptoms, except two cases of early diagnosis without symptom. Surgical resection of the remnant stomach was performed in 13 patients of which 11 patients underwent a curative resection with curative intent. Of these 13 patients, a combined resection of adjacent organs was performed in 10 cases. Fifteen patients had advanced gastric cancer, most of which involved depth of invasions to seromuscular layers, and lymph-node metastases were found in 8 patients. Most of patients who underwent bypass surgery or palliative resection died within 1 year of the operation. Among the 11 patients who underwent a curative resection, 3 patients died within 1 month of the operation due to postoperative complications, 2 patients died of recurrent cancer, and another 6 patients are alive without evidence of recurrence. CONCLUSIONS: Eearly detection of gastric cancer in the remnant stomach by periodic follow up is important, especially in high-risk groups, and the application of aggressive surgical treatment will provide for better patient survival.
Diagnosis ; Duodenal Ulcer ; Early Diagnosis ; Gastrectomy* ; Gastric Stump* ; Humans ; Male ; Neoplasm Metastasis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Stomach Ulcer

PURPOSE: Prognosis of primary gastric cancer invading neighboring organs is very poor. However, with en bloc resection, a relatively favorable prognosis can be expected even in patients with such advanced cancer. But there has been controversy on the effectiveness of gastrectomy combined with en bloc resection of the invaded organs, and we conducted this study to evaluate the prognostic effects as well as the outcome of the combined resection. MATERIALS AND METHODS: Among 2,603 who underwent gastrectomy due to gastric carcinoma from January 1987 to December 1994 at the Department of Surgery, Yonsei University College of Medicine, 157 patients (6.0%) in whom curative combined resections of grossly invaded adjacent organs (cT4) were perfonned entered this study. Any case with distant metastasis was excluded. Comparisons and multivariate analysis between the invasion (pT3) group and the non-invasion (pT4) group were made for age, sex, tumor size, location, Borrmann type, depth of invasion, lymph node metastasis, histologic type and 5-year survival rate. RESULTS: One-organ combined resection was done in 60 (38.2%) patients; Two-organ, in 80 (51.0%) patients; and three-organ, in 17 (10.8%) patients. Most commonly combined organ was distal pancreas and transverse colon was the next. Histologic confirmation of invasion was made in 40.9%. 157 patients with T4 were divided into pT3 or pT4. Significant differences were found in type of operation, location of tumor, and TNM staging. Postoperative complications of combined resection were observed in 48 cases (30.6%) and the wound infection was the most frequent one. There were only 2 cases (1.3%) of immediate postoperative mortality in the combined group, and the causes of death were pulmonary complication and acute renal failure. Five-year survival rate (5-YSR) of pT3 group was 43.0% and that of pT4 was 26.2%. In comparison of 5-YSR according to TNM stages, no significant difference was found between pT3 and pT4 (45.0% vs. 66.7% in IIIa; 25.4% vs. 18.4% in IV). No difference of 5-YSR was observed in the groups categorized according to the number of resected organs. The comparison of 5-YSR between the 157 curatively-combined cases and the 63 palliatively-combined cases showed a significant difference (35.6% vs. 4.2%, p=0.000). Multivariate analysis showed that lymph node metastasis and microscopic tumor invasion served as significant parametets. CONCLUSION: En bloc combined resection of adjacent invaded organs along with systematic lymph node dissection would be beneficial to gastric cancer patients with neighboring organ invasion.
Acute Kidney Injury ; Cause of Death ; Colon, Transverse ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Pancreas ; Postoperative Complications ; Prognosis ; Stomach Neoplasms* ; Survival Rate ; Wound Infection

PURPOSE: Alternative splicing of CD44 and aberrant levels of soluble CD44 (sCD44) protein in the serum of cancer patients has been correlated to tumor progression and metastasis. The purpose of this study was to evaluate the concentrations, and the prognostic potential of sCD44s, sCD44v5 and sCD44v6, in patients with gastric cancer. MATERIALS AND METHODS: The serum levels of sCD44s, sCD44v5 and sCD44v6 were determined quantitatively using an enzyme-linked immunosorbent assay. Serum samples were obtained from 116 patients with gastric cancer, both before and after surgery, and from 30 healthy controls. RESULTS: The serum sCD44v6 levels were significantly higher in patients with gastric cancer than in the healthy controls, whereas those of sCD44s and sCD44v5 were no different. The surgical resection of the tumor resulted in a significant reduction in all the sCD44 proteins, whereas if a surgical resection was not performed the concentrations of the sCD44v5 and sCD44v6 were not reduced prior to surgery. The serum sCD44v6 levels correlated with the venous or lymphatic invasion of the tumor and lymph node metastasis. In addition, a high preoperative serum sCD44v6 level was significantly associated with poor prognosis in patients with gastric cancer. CONCLUSION: The preoperative serum level of sCD44v6 in patients with gastric cancer was significantly higher than that in the healthy controls, and correlated with the venous or lymphatic invasion of the tumor and lymph node metastasis. In addition, a high preoperative serum sCD44v6 level was significantly associated with poor prognosis in patients with gastric cancer. These results suggest that an elevation of the serum sCD44v6 level might be used as a new predictor of tumor invasiveness, and poor prognosis, in patients with gastric cancer.
Alternative Splicing ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms*

No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Korea* ; Prevalence*

Foreign bodies in genitourinary tract are common and almost of then are within the bladder. These foreign bodies were inserted or applied for autoerotic, psychiatric, therapeutic, or no definite reasons by the patient. Foreign bodies(a thermometer and a piece of cloth) in the bladder were inserted as a mean of masturbation in two cases, and a cooper wire in the posterior urethra was introduced by iatrogenic causes in one case. In one case, four magnets were inserted into the bladder for the purpose of forceful penile erection. Clinical history, symptom, radiologic study, and endoscopic examination were required to diagnose foreign body. They were easily removed by endoscopic manipulation or open surgical procedure.
Foreign Bodies* ; Humans ; Male ; Masturbation ; Penile Erection ; Thermometers ; Urethra ; Urinary Bladder ; Urinary Tract*