No abstract available.
Neuroectodermal Tumor, Melanotic

To evaluate the effects of the preoperative chemoradiation therapy(CRT) for rectal cancer. 31 rectal cancer patients received preoperative CRT. A total 3060cGy of radiation was given in 3 weeks, 180cGy for a fraction. 425mg/m2/day of 5-FU and 20mg/m2/day of leucovorin were continuously infused in the first 5 days of the preoperative radiation therapy. A IV injection of Mitomycin C 10mg/m2 was given on the first day. A digital rectal examination, endoscopy with biopsy, barium enema, chest X-ray, hepatobiliary ultrasonography & IV bolus CT were done before and after CRT. Clinically, 19 patients(61.3%) and pathologically, 16 patients(51.6%) showed reduced tumor size. In 7 patients (22.6%), there was no residual tumor in the pathologic specimen. Digital rectal examination was possible in 23 patients. 16(69.5%) of them had a decrease in height of ulcer margin on digital rectal examination. Seven of the fifteen patients showed decreased perirectal fat tissue infiltration. There was no severe toxicity which might delay the curative surgery. In conclusion, preoperative chemoradiation therapy in rectal cancer was very effective in reducing tumor size and perirectal fat tissue infiltration without considerable toxicity.
Barium ; Biopsy ; Digital Rectal Examination ; Endoscopy ; Enema ; Fluorouracil ; Humans ; Leucovorin ; Mitomycin ; Neoplasm, Residual ; Rectal Neoplasms ; Thorax ; Ulcer ; Ultrasonography

Obturator hernia is a rare type of pelvic hernia and occurs most commonly in elderly and debilitated women. It is still a challenge for surgeons to diagnose precisely in early stages because of its nonspecific symptoms and consequently delayed diagnosis could lead to high morbidity and mortality. We experienced a 92-year old patient who was diagnosed as obturator hernia which was confirmed by computed tomography scan of the abdomen and pelvis. The operation was delayed due to the refusal of family members but eventually done after 12 days from initial diagnosis. After manual reduction of small bowel impacted into right obturator foramen, segmental resection of impacted small bowel and anastomosis was done. The hernial defect was closed by primary closure with Dexon suture material. After the operation, the patient was discharged without significant complications. We report here successful results of delayed operation for obturator hernia.
Abdomen ; Aged ; Benzenesulfonates ; Delayed Diagnosis ; Disulfiram ; Female ; Hernia ; Hernia, Obturator ; Humans ; Pelvis ; Sutures

PURPOSE: To evaluate the usefulness of preoperative MRI in the patient with recurrent anorectal fistula. MATERIALS AND METHODS: Fourteen patients with recurrent anorectal fistula underwent non-contrast MRI. In eight patients, T1-, T2- and proton-weighted images were taken in the axial, coronal and sagittal planes, and T1- andT2-weighted images taken in the axial and coronal planes were obtained from the other six. RESULTS: Fourteen cases of anorectal fistula and eight cases in which there was a combined abscess were detected. Preoperative MRI clearly showed the exact anatomical relationship with the anal sphincter, levator ani and surrounding soft tissue. In two cases in which there was fibrous scarring of the fistula tract, low signal intensities were seen on all MRI sequences. Preoperative information in the group in which only axial and coronal T1- and T2-weighted images were obtained was sufficient. CONCLUSION: Preoperative MRI in patients with recurrent anorectal fistula or suspected multiple fistulous tracts provide objective information concerning the anatomical location and extension of a fistula and combined abscess and could thus reduce the reoperation rate. An understanding of pathologic state through MRI signal intensity can help decide the most appropriate course of treatment.
Abscess ; Anal Canal ; Cicatrix ; Fistula* ; Humans ; Magnetic Resonance Imaging* ; Reoperation

The ultimate goal of periodontal therapy is directed to arresting the progression of the disease, and regenerating the fibrous attachment. In order to achieve such treatment aim, the plaque and calculus must be eliminated and the physiological conditions of the root surface must be changed to facilitate the attachment and migration of the new fibroblasts, The method of changing the proper root surface conditions to promote the healing of periodontal tissue involves mechanical procedures, such as scaling and root planing, and chemical procedures such as tetracycline-HCl. However, the formation of a long junctional epithelium was most frequently observed type of healing. Thus, the aim of this study was to examine in vitro the influence of surface conditioning of dentin by TC-HCl on human gingival epithelial cell attachment. Human gingival epithelial cells were obtained from healthy retromolar pad area(under the age 23 years). Seventy two teeth extracted from severe periodontitis were used as study material. To evaluate the epithelial cell attachment to dentin, the prepared specimen was divided to four groups. For the control group, only scaling and root planing were carried out, and for the test group, 1 to 3, the concentration of the TC-HCl was 50, 125 and 250mg/ml, respectively. After cell cultivation time of 1-, 3-. 24 hour, for the indirect quantitative assessment of gingival epithelial cell attached to dentin sample, the absorbance of epithelial cell unattached to dentin was measured. The results were as follows; 1. There was no statistically significant difference between scaling and root planing group and TC-HCl 50mg/ ml, 125mg/ml and 250mg/ml group about absorbance of unattached epithelial cell to dentin sample(p>0.5). 2. As time passes, the absorbance of unattached gingival epithelial cell to dentin sample was decreased statistically significant(p<0.05). 3. There was no statistically significant difference among the TC-HCl group(p>0.05) We concluded that there was similar effect on gingival epithelial cell attachment between TC-HCl conditioning on root surface and only scaling and root planing treatment
Calculi ; Dentin ; Epithelial Attachment ; Epithelial Cells* ; Fibroblasts ; Humans ; Periodontitis ; Root Planing ; Tooth

PURPOSE: Limited data is available about the relative effects of laser wavelengths when conducting endovenous laser treatment (EVLT) for saphenous vein incompetence. We performed this study to compare the safety and efficacy between EVLT with using an 810 nm and a 1,320 nm laser. METHODS: 147 incompetent saphenous veins in 101 consecutive patients who were treated with EVLT were included in this study. We divided them into two groups: 810 in the nm laser group (Group A: 85 saphenous veins in 52 patients) and 1,320 in the nm laser group (Group B: 62 saphenous veins in 49 patients). The patients were evaluated with Doppler sonography to evaluate the results of the treatment at 1 and 3 months after the procedure. Symptomatic improvement was compared between the groups according to the venous clinical severity score (VCSS), the Averdeen varicose vein symptom severity score (AVSS), the complications, the recurrences and the recanlization rate. RESULTS: There was a statistically significant difference in an average linear endovenous energy density (LEED) between two groups. During the mean follow-up of 139 days in Group A and 116 days in Group B, more complications occurred in Group A (42.3%) than that in Group B (32.7%). The postoperative clinical improvement was similar between the two groups for the VCSS and AVSS. The ultrasonography (USG)-proved recanalizaton rates at postoperative 1 and 3 months were 1.2% and 4.3% in Group A and 1.6% and 1.9% in Group B, respectively. Recurrences occurred in only 2 cases in Group A. CONCLUSION: EVLT with a 1,320 nm laser had a tendency to develop fewer complications, recurrences and USG-proven recanalizations of the saphenous veins. Long-term data from large randomized prospective trials is needed to confirm the safety and efficacy of this operative procedure.
Follow-Up Studies ; Humans ; Recurrence ; Saphenous Vein ; Varicose Veins

BACKGROUNDS/AIMS: We aimed to to evaluate the feasibility of laparoscopic common bile duct exploration (LCBDE) in patients with previous upper abdominal surgery. METHODS: Retrospective analysis was performed on data from the attempted laparoscopic common bile duct exploration in 44 patients. Among them, 5 patients with previous lower abdominal operation were excluded. 39 patients were divided into two groups according to presence of previous upper abdominal operation; Group A: patients without history of abdominal operation. (n=27), Group B: patients with history of upper abdominal operation. Both groups (n=12) were compared to each other, with respect to clinical characteristics, operation time, postoperative hospital stay, open conversion rate, postoperative complication, duct clearance and mortality. RESULTS: All of the 39 patients received laparoscopic common bile duct exploration and choledochotomy with T-tube drainage (n=38 [97.4%]) or with primary closure (n=1). These two groups were not statistically different in gender, mean age and presence of co-morbidity, mean operation time (164.5+/-63.1 min in group A and 134.8+/-45.2 min in group B, p=0.18) and postoperative hospital stay (12.6+/-5.7 days in group A and 9.8+/-2.9 days in group B, p=0.158). Duct clearance and complication rates were comparable (p>0.05). 4 cases were converted to open in group A and 1 case in group B respectively. In group A (4 of 27 (14.8%) and 1 of 12 (8.3%) in group B, p=0.312) Trocar or Veress needle related complication did not occur in either group. CONCLUSIONS: LCBDE appears to be a safe and effective treatment even in the patients with previous upper abdominal operation if performed by experienced laparoscopic surgeon, and it can be the best alternative to failed endoscopic retrograde cholangiopancreatography for difficult cholelithiasis.
Cholangiopancreatography, Endoscopic Retrograde ; Cholelithiasis ; Common Bile Duct ; Drainage ; Humans ; Length of Stay ; Needles ; Postoperative Complications ; Retrospective Studies ; Surgical Instruments

Dermatofibrosarcoma protuberans is a rare tumor that occurs in the dermis or subcutaneous tissue of the trunk or extremities in relatively young adults. There are few reports of Dermatofibrosarcoma protuberans associated with pregnancy. We experienced a 28-year-old pregnant female patient with an abdominal wall mass, which grew rapidly during pregnancy. Excisional biopsy was performed and the pathologic diagnosis was fibrosarcoma transformed from Dermatofibrosarcoma protuberans. Dermatofibrosarcoma protuberans showed a positive CD34 immunostaining while fibrosarcoma showed a negative CD34. There was no recurrence or metastasis with the follow up period of 2 years. We report here a rare case of Dermatofibrosarcoma protuberans aggravated during pregnancy with a review of the literature.
Abdominal Wall ; Adult ; Biopsy ; Dermatofibrosarcoma ; Dermis ; Extremities ; Female ; Fibrosarcoma ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Pregnancy ; Recurrence ; Subcutaneous Tissue ; Young Adult

PURPOSE: For the treatment of residual visible tributaries following minimally invasive saphenous vein ablation procedures such as endovenous laser treatment (EVLT) and radiofrequency ablation (RF), a variety of options including observation, sclerotherapy, ultrasonography-guided sclerotherapy, stab phlebectomy (SP) and additional laser therapy have been developed. We performed endovenous laser treatment combined with stab phlebectomy and we evaluated the early results to assess the efficacy and safety of this procedure. METHODS: Between February 2003 and February 2006, one hundred twelve venous insufficiencies of the lower limbs in 106 patients (46 men and 60 women; mean age: 51.7 years) were treated with EVLT combined with SP. According to the CEAP classification, 103 limbs were C2, and nine were C3/C4. 810-nm diode laser energy was delivered percutaneously into the saphenous veins (86 GSVs, 20 SSVs, 6 GSV+SSVs). All patients were followed up on an outpatient basis and duplex ultrasonography (US) was performed 3 months after operation. RESULTS: The mean follow-up period was 2.92 months. All the patients had symptomatic improvement and immediately returned to normal daily activities. The overall complication rate was 36.6% (41 cases), and most of them were minor problems including ecchymosis in 22, paresthesia in 8, induration in 5 and excessive pain in 2. Three cases of cellulitis or thrombophlebitis were present and this resolved with drainage and antibiotics. One case of foot drop developed, but this improved with active physiotherapy within a few months. No postprocedural symptomatic deep vein thrombosis occurred. The recurrence rate of tributaries at 3 months was 13.6%, but these were easily controlled by sclerotherapy if needed. The duplex US-confirmed saphenous vein recanalization rate at 3 months was 5.9%. CONCLUSION: EVLT combined with SP could be a novel minimally invasive modality for treating lower extremity varicose veins with an acceptable complication rate and a low recanalization rate of the saphenous veins. It could lessen the possibility of additional treatments for the residual visible tributaries and so improve the satisfaction index, along with the cosmetic and economic advantages. However, long-term follow up and postoperative duplex US with an additional objective index examination are required to confirm the effectiveness and durability of this operative procedure.
Anti-Bacterial Agents ; Catheter Ablation ; Cellulitis ; Classification ; Drainage ; Ecchymosis ; Extremities ; Female ; Follow-Up Studies ; Foot ; Humans ; Laser Therapy ; Lasers, Semiconductor ; Lower Extremity* ; Male ; Outpatients ; Paresthesia ; Recurrence ; Saphenous Vein ; Sclerotherapy ; Surgical Procedures, Operative ; Thrombophlebitis ; Ultrasonography ; Varicose Veins* ; Venous Insufficiency ; Venous Thrombosis

Primary omental tumors are rare, with most being metastatic, especially those from intra-abdominal organs. Breast and lung malignancies, as well as melanomas, are frequent causes of extra-abdominal cancers metastasizing to the omentum, peritoneum and mesentery. The case of a metastatic omental melanoma from the choroid of the eye was experienced, which formed a solitary mass in the omentum similar to that of a primary omental tumor. The patient was unaware of the nature of her eye disease following enucleation seven years previously. Concomitant liver metastases were also not identified on a CT scan, due to their relatively small sizes. Therefore, the metastatic melanoma was misconceived as a primary omental tumor until laparotomy and pathologic confirmation. This case shows that a metastatic melanoma can be presented as an abdominal mass, and should be considered in the differential diagnosis of an intra-abdominal mass.
Breast ; Choroid* ; Diagnosis, Differential ; Eye Diseases ; Humans ; Laparotomy ; Liver ; Lung ; Melanoma* ; Mesentery ; Neoplasm Metastasis ; Omentum ; Peritoneum ; Tomography, X-Ray Computed