We reported a case of subchorionic placental cyst with maternal floor infarction in 32-year-old multigravida. In this case the infant without growth retardation was delivered at fuU term by repeat cesarean section. A 5.8*5cm placental cyst detected prenatally by ultrasound was shown subsequentty to be a subchorionic cyst without thrombohematoma. The cyst was unilocular and attached near the cord insertion, and it contained straw-colored fluid. There was no other placental abnormalities except placental inFarction on matemal floor with fibrin deposition. It is necessary to differentiate placental cystic lesions by ultrasonographic and pathologic examination because placental abnormalities could be associated with perinatal complications.
Adult ; Cesarean Section, Repeat ; Female ; Fibrin ; Humans ; Infant ; Infarction* ; Placenta ; Ultrasonography

PURPOSE: Clostridium difficile (C. difficile)-associated colitis, a known complication of colon and rectal surgery, can increase perioperative morbidity and mortality, leading to increased hospital stay and costs. Several contributing factors, including advanced age, mechanical bowel preparation, and antibiotics, have been implicated in this condition. The purpose of this study was to determine the clinical features of and factors responsible for C. difficile-associated colitis after colorectal cancer surgery. METHODS: The medical records of patients who had undergone elective resection for colorectal cancer from January 2008 to April 2010 were reviewed. Cases that involved procedures such as transanal excision, stoma creation, or emergency operation were excluded from the analysis. RESULTS: Resection with primary anastomosis was performed in 219 patients with colorectal cancer. The rate of postoperative C. difficile-associated colitis was 6.8% in the entire study population. Preoperative metallic stent insertion (P = 0.017) and aged sixty and older (> or = 60, P = 0.025) were identified as risk factors for postoperative C. difficile-associated colitis. There were no significant differences in variables such as preoperative oral non-absorbable antibiotics, site of operation, operation procedure, and duration of prophylactic antibiotics. CONCLUSION: Among the potential causative factors of postoperative C. difficile-associated colitis, preoperative metallic stent insertion and aged sixty and older were identified as risk factors on the basis of our data. Strategies to prevent C. difficile infection should be carried out in patients who have undergone preoperative insertion of a metallic stent and are aged sixty and older years.
Aged ; Anti-Bacterial Agents ; Clostridium ; Clostridium difficile ; Colitis ; Colon ; Colorectal Neoplasms ; Emergencies ; Humans ; Length of Stay ; Medical Records ; Risk Factors ; Stents

BACKGROUND: The optimum surgical treatment for rectal prolapse is controversial, and many different operations have been described. The aim of this study is to evaluate the results of a perineal procedure for the treatment of rectal prolapse. METHODS: Between February 1990 and March 1997, 16 consecutive patients underwent perineal rectosigmoidectomy for a complete rectal prolapse. One patient was lost to follow up. The remaining 15 patients were followed up for an average of 58.4 (9~94) months, and clinical and functional outcomes were evaluated. RESULTS: There were 8 males and 7 females, and ages ranged from 18 to 65 years. The mean prolapse duration was 10.7 (0.25~30) years. There were no postoperative deaths. Two patients developed postoperative complications (one wound infection and the other wound hematoma). Five patients had fecal incontinence prior to surgery. Three of the five patients had improved fecal incontinence after the procedure. There were three recurrences (recurrence rate of 20%): one of them underwent a Delorme operation at our institution and others had no treatment. CONCLUSION: A perineal rectosigmoidectomy is a safe and effective operation for the primary treatment of rectal prolapse and has low mortality and morbidity.
Fecal Incontinence ; Female ; Humans ; Lost to Follow-Up ; Male ; Mortality ; Postoperative Complications ; Prolapse ; Rectal Prolapse* ; Recurrence ; Wound Infection ; Wounds and Injuries

BACKGROUND : The purpose of this study was to determine whether the Billroth I method using an EEA stapler is safe, reliable, and easy-to-use for treatment of gastric cancer compared with a distal gastrectomy with conventional manual anastomosis. METHODS : A prospective comparative study was performed between forty patients with EEA stapling and thirty patients with manual suturing during gastroduodenostomies performed during the past three years with respect to operation time, diameter of anastomosis, postoperative clinical course, and post operative complications. RESULTS : The operation time was significantly shortened by about 50 minutes on the average, in the cases where the EEA stapler was used (p<0.001). On postoperative hypotonic duodenography, the diameter of the anastomosis was significantly larger in the cases where the EEA stapler was used (p< 0.001). However, the postoperative clinical course showed no difference between the two groups. Complications, such as anastomotic stenosis and anastomotic leak age were noted only in the cases where manual suturing was used. CONCLUSIONS : A gastroduodenostomy using the EEA stapler might be a faster, simpler and safer pro cedure compared with the gastroduodenostomy using the conventional manual anastomosis.
Anastomotic Leak ; Bezafibrate ; Constriction, Pathologic ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Prospective Studies ; Stomach Neoplasms ; Stomach*

PURPOSE: The purpose of this study was to evaluate the clinicopathological significance of responders with metastatic colorectal cancer treated with oxaliplatin chemotherapy. METHODS: A total of 52 patients with unresectable metastatic colorectal cancer were enrolled for treatment between March 2000 and August 2005. Patients received first line chemotherapy consisted of oxaliplatin 85 mg/m2 or 130 mg/m2 as a 2-hour infusion on day 1, concurrently with leucovorin (LV) 20 mg/m2 as a bolus infusion on day 1~5, followed by continuous infusion of 5-fluorouracil (5-FU) 425 mg/m2 on day 1~5. This treatment was repeated in 2 or 3 week intervals. All responses were assessed after 4 cycles of therapy by independent radiologic experts and categorized into two groups: responder (major reduction of tumor) and non-responder group (no change or progression of the tumor. RESULTS: The response rate was 51.9 percent (27/52 patients). There were no significant differences in clinicopathologic parameters between two groups. The decrease of CEA value after chemotherapy was significantly more frequent in the responder group than in the non-responder group. CONCLUSIONS: We could not find any clinical differences between the two groups, but these results suggest that oxaliplatin chemotherapy has a beneficial effect on tumor shrinkage and serum CEA value can be an indicator for tumor response of oxaliplatin in advanced colorectal cancer.
Colorectal Neoplasms* ; Drug Therapy* ; Fluorouracil ; Humans ; Leucovorin

Medullary thyroid carcinomas (MTC) are rare tumors that account for approximately 5-10% of all thyroid malignancy in the West. The reported incidence of MTC is less than 5% in Korea. Its prognosis is relatively good with a 15-year survival rate of 64-84%. The incidence of thyroid cancer has been increasing rapidly worldwide and the overall survival of patients with thyroid cancer is excellent. The occurrence of second primary malignancy (SPM) among survivors of thyroid cancer is a concern, together with life expectancy. Recent studies reported a 6-45% increase in the risk of developing SPM after the diagnosis thyroid cancer. We reported a patient with prostate and colon cancer that were diagnosed 10 years after the diagnosis of medullary thyroid carcinoma.
Aged* ; Colonic Neoplasms* ; Diagnosis* ; Humans ; Incidence ; Korea ; Life Expectancy ; Prognosis ; Prostate ; Prostatic Neoplasms* ; Survival Rate ; Survivors ; Thyroid Gland ; Thyroid Neoplasms*

The Roux-en-Y esophagojejunostomy is one of the most common means of reconstructive surgery after a total gastrectomy. While these Roux operations work well in the majority of patients, approximately 30% of individuals undergoing them develop the so-called Roux stasis syndrome, consisting of chronic abdominal pain, nausea, vomiting, and postprandial bloating. The Roux stasis syndrome is thought to result from the jejunal transsection performed during the construction of a conventional Roux limb. The aim of this study was to review a new type of uncut Roux procedure, in which staple lines and loop ligation maintain myoneural continuity and prevent the Roux stasis syndrome between the proximal jejunum and the Roux limb. At the same time, a jejunojejunostomy provides distal diversion of pancreaticobiliary secretions. The postoperative courses of 23 cases of the uncut Roux procedure with staples after a total gastrectomy were compared with those of 18 cases of afferent proximal loop ligation with hand-sewn sutures, the procedures having been performed between May 1995 and January 1997. Passage of contrast media through the ligated afferent jejunal loop was identified in 34.8% of cases and occluded staple lines was identified in 38.9% of cases. It was found that the uncut Roux procedure prevents the Roux stasis syndrome and that the current technique has a high incidence of dehiscence of the staple lines and the loop ligation with subsequent reflux esophagitis. Because of the results reported here, other techniques, which maintain enteric myoneural continuity to an uncut Roux limb while providing complete and permanent diversion of the alkaline secretions distally from the esophagus, need to be developed before this type of anatomic reconstruction can be recommended.
Abdominal Pain ; Contrast Media ; Esophagitis, Peptic ; Esophagus ; Extremities ; Gastrectomy* ; Humans ; Incidence ; Jejunum ; Ligation ; Nausea ; Sutures ; Vomiting

Few studies have examined the clinical features and long-term outcomes of isolated pituitary hormone deficiencies after traumatic brain injury (TBI). Such deficiencies typically present at time intervals after TBI, especially after mild injuries such as concussions, which makes their diagnosis difficult without careful history taking. It is necessary to improve diagnosis and prevent life threatening or morbid conditions such as those that may occur in deficiencies of adrenocorticotropic hormone (ACTH) or thyroid-stimulating hormone (as known as thyrotropin, TSH), the two most important pituitary hormones in hypopituitarism treatment. Here, we report two cases of isolated ACTH deficiency and one case of isolated TSH deficiency. These patients presented at different time points after concussion and underwent long-term follow-ups.
Adrenocorticotropic Hormone* ; Brain Injuries* ; Diagnosis ; Follow-Up Studies* ; Humans ; Hypopituitarism ; Pituitary Hormones ; Thyrotropin*

No abstract available.
Humans ; Hyperparathyroidism, Primary ; Parathyroid Neoplasms* ; Schizophrenia* ; Thyroid Gland* ; Thyroid Neoplasms*

The purpose of this study was to evaluate the effects of routine haecho bibimbab (boiled rice with assorted seaweed mixtures) consumption on the bowel habits in humans. Forty free-living adults (female 38, male 2) participated in this study (mean age 41.2 +/- 7.5). After a baseline survey on general characteristics, life style and dietary habits, the participants were asked to consume haecho bibimbab during two-week period for lunch. Habitual bowel movements were checked out every day by a questionnaire and nutrient intake was estimated by a 24-hour recalls before and after the study. After 2 weeks of clinical trial, the bowel habits had improved. Haecho bibimbab increased the number of bowel movements, changed hard stools into softer ones. It also lessen the sense of incomplete evacuation, and abdominal pain during defecation, increased water intake (p < 0.001) and improved gastrointestinal problem. The participants believed that haecho bibimbab was effective in improving their constipation symptoms and bowel habits (p < 0.01). Routine haecho bibimbab consumption tended to increase especially vitamin A, E and folate intake (p < 0.01). The present findings suggest that routine seaweed-based lunch meal (haecho bibimbab) consumption may improve bowel habits without side effects.
Abdominal Pain ; Adult ; Constipation ; Defecation ; Drinking ; Folic Acid ; Food Habits ; Humans ; Life Style ; Lunch ; Male ; Meals ; Surveys and Questionnaires ; Seaweed ; Vitamin A