Fibrous hamartoma of infancy is an uncommon, benign fibroproliferative tumor arising from sub. cutaneous tissue during the First 2 years of life. We report a case of fibrous hamartoma of infancy in the scrotum. The clinical characteristics and management of this neoplasm are discussed with references.
Hamartoma* ; Scrotum*

We reviewed retrospectively 16 cases of renal or perirenal abscess who were admitted to the St. Mary hospital during the period from January 1977 to December 1986. The results were as follows : 1. The average age of the patients was 27 years. 2. The average duration of symptom was 15 days. 3. On laboratory findings, 6 cases (31%) of pyuria and 2 cases (13%) of positive urine culture were seen. 4. Abscess culture was performed in 10 patients and 5 cases of staphylococcus and 2 cases of E. coli were cultured. The remained 3 cases were sterile culture. 5. Predisposing factors were involved in 6 cases (38%). Urologic predisposing factors were 5 cases (31%) and non-urologic predisposing factors were 4 cases (25%). 6. Surgical treatment was performed in 10 cases (63%) by 9 cases of incision & drainage and 1 case of nephrectomy. Non-surgical treatment was successful in 6 cases (37%) by 5 cases of antibiotics only and by 1 case of antibiotics with ultrasound guided percutaneous drainage.
Abscess* ; Anti-Bacterial Agents ; Causality ; Drainage ; Humans ; Nephrectomy ; Pyuria ; Retrospective Studies ; Staphylococcus ; Ultrasonography

BACKGROUND/AIMS: Hepatoduodenal ligament lymph node (LN) dissection has been performed as a part of extended LN dissection during the operation for gastric cancer. And additional cholecystectomy has been performed for more radical node dissection and prevention of cholelithiasis in some centers. There are rare studies and reports about the injury of bile duct system with the operation for gastric cancer. The aim of this study is to evaluate the risk of biliary tree injury with LN dissection for gastric cancer. METHODS: 254 patients of gastric cancer were treated with gastrectomy with LN dissection at Kangnam general hospital between January 1996 and December 2001. Among this group, 151 patients of advanced gastric cancer underwent extended LN dissection of D2+alpha or D3 including hepatoduodenal ligament LN and 69 patients of early gastric cancer underwent D2. And we routinely conducted cholecystectomy for advanced and early gastric cancer. Of these patients, 5 cases without remained or recurred tumor of bile leakage after operation were reviewed. And we analyzed the changes of liver function tests (LFT) of 15 patients of early gastric cancer and 21 patients of advanced gastric cancer whose LFT follow-up data were available. RESULTS: The rate of bile leakage was 2.3% (5 patients) after LN dissection of hepatoduodenal ligament for gastric cancer. Among this group, 3 patients underwent reoperation due to unexpected bile leakage and 2 patients underwent T tube choledochostomy due to minor injury to common hepatic duct on operation. One patient died of sepsis with continued bile leakage after T tube removal on the postoperative 41st day. The serum alkaline phosphatase was increased after operation especially in advanced gastric cancer without clinical significance and there was no other significant abnormality in LFT after hepatoduodenal LN dissection and cholecystectomy in non-recurrent cases. CONCLUSION: Extended lymph node dissection including hepatoduodenal ligament LN and cholecystectomy may have the possibility of increasing the risk of bile duct injury. It is important to select the patients who will benefit from hepatoduodenal ligament LN dissection and cholecystectomy. And meticulous surgical technique to operate biliary tract and adequate management of biliary injury are needed.
Alkaline Phosphatase ; Bile Ducts* ; Bile* ; Biliary Tract ; Cholecystectomy ; Choledochostomy ; Cholelithiasis ; Follow-Up Studies ; Gastrectomy ; Hepatic Duct, Common ; Hospitals, General ; Humans ; Ligaments ; Liver Function Tests* ; Liver* ; Lymph Node Excision ; Lymph Nodes ; Reoperation ; Sepsis ; Stomach Neoplasms*

PURPOSE: In gastric cancer, metastasis to the paraaortic lymph nodes had been regarded as an incurable factor, but many cases of long term survival have been reported with dissection of metastatic paraaortic nodes. And several reports suggested survival benefit with paraaortic lymph node dissection (D4) in advanced gastric cancer. In patients with advanced gastric cancer who underwent paraaortic lymph node dissection we tried to evaluate the factors predisposing metastasis in these nodes and survival data. MATERIALS AND METHODS: The authors analyzed retrospectively pathological features of 95 patients who underwent paraaortic lymph node dissection for advanced gastric cancer at Kangnam General Hospital Public Corporation from May 1991 to Feb. 1998. And we also analysed survival results of 72 cases among them. We excluded 18 cases of distant metastasis (3 liver metastasis, 15 peritoneal seeding), 2 operative mortalities, 1 other disease mortality, and 2 unknown causes of death in survival analysis. RESULTS: The frequencies of paraaortic lymph node metastasis were 0.0% (0 of 32 cases) in T2, 19.2% (10 of 52 cases) in T3, 18.2% (2 of 11 cases) in T4. And those of paraaortic lymph node metastasis were 5.8% (3 of 52 cases) in antrum, 14.3% (3 fo 21 cases) in body, 20.0% (3 of 15 cases) in cardia, and 42.9% (3 of 7 cases) in whole area. The five-year survival rates (5 YSR's) in relation to the paraaortic lymph node (No16) status was 0.0% in No16 , and 57.8% in No16 with D4 of advanced gastric cancer. The 5 YSR's were 78.1%, 40.8% and 0% in T2, T3 and T4, respectively and 93.8%, 64.2%, 24.2% and 0.0% in n0, n1, n2 and n3, respectively and 88.9%, 80.5%, 57.9% and 0.0% (47.6%) and 0.0% in stage IB, II, IIIA, IIIB and IV, respectively. CONCLUSION: The depth of gastric wall invasion and the location of primary tumor were significant predisposing factors to para-aortic lymph node metastasis in multivariate analysis (p<0.05). Survival of No16 metastasis was very poor. And three factors of T stage, n stage, and Borrmann type were also prognostically significant in terms of five year survival in cases of D4 of advanced gastric cancer in multivariate analysis (p<0.05).
Cardia ; Causality ; Cause of Death ; Hospitals, General ; Humans ; Liver ; Lymph Node Excision* ; Lymph Nodes* ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

PURPOSE: We compared the clinical results of paraaortic lymph node dissection (PALD) with those of D2 to evaluate the survival gain and disadvantage of paraaortic lymph node dissection for advanced gastric cancer. MATERIALS AND METHODS: We analysed the clinical data of 196 patients who underwent curative resection and D2 with or without paraaortic lymph node dissection (PALD or D2) for advanced gastric cancer from May 1990 to June 1999. The operative factors (operative time, the amounts of intraoperative transfusion and hospital stay), operative morbidity and mortality and 5 year survival rates were compared between D2 and PALD groups. RESULTS: The operative time of subtotal gastrectomy was significantly longer in PALD group than D2 group. The operative morbidity rates were 9.2% in D2 group and 10.3% in PALD group. There were 3 operative mortalities in D2 group and none in PALD group. The 5 year survival rates (5YSR's) of stage IB, II, IIIA, IIIB, IV were 88.9%, 92.3%, 30.2%, 24.2%, 28.9% in D2 group and 93.3%, 75.5%, 61.0%, 0%, 0% in PALD group. CONCLUSION: The paraaortic lymph node dissection was a rather safe procedure without significant increase of morbidity and mortality. There was no statistically significant difference in survival in any stage of this retrospective study with limited cases and follow-ups.
Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Node Excision* ; Lymph Nodes* ; Mortality ; Operative Time ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

PURPOSE: Prophylactic antibiotics have been used in nonperforated appendicitis for preventing infection after an appendectomy. However, the duration of antibiotic administration for surgical prophylaxis in Korea has been noted to be longer than those recommended in other countries. PURPOSE: The objective of this study was to identify the appropriate duration of prophylactic antibiotic therapy in nonperforated appendicitis by comparing the wound infection rates of two different antibiotic regimens, 24 hours of cephalosporin (cefoxitin) alone and 72 hours of cephalosporin (cefoxitin) with aminoglycoside (sissomicin). METHODS: One hundred thirty-four (134) patients of nonperforated appendicitis were enrolled in this prospective, randomized, open trial and were assigned to one of two antibiotic regimens: 1) cefoxitin 1 g every 8 hours given intravenously for 24 hours and 2) cefoxitin 1 g every 8 hours given intravenously plus sissomicin 75 mg every 12 hours given intramuscularly for 72 hours. First doses were given just prior to the induction of anesthesia. RESULTS: Postoperative wound infections were detected in 3 cases (4.5%) of the 72-hour-treated group (n=66) whereas none occurred in the 24-hour-treated group (n=68). However, the difference in the rates of wound infections between the two groups was not statistically significant. Cost analysis identified a saving of 43,470 won per patient in the 24-hour-treated group. CONCLUSION: In nonperforated appendicitis cefoxitin administration alone for 24 hours is sufficient as a surgical prophylaxis.
Anesthesia ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis* ; Cefoxitin ; Costs and Cost Analysis ; Humans ; Korea ; Prospective Studies* ; Sisomicin ; Surgical Wound Infection ; Wound Infection

PURPOSE: Previous retrospective studies suggest that anaplastic lymphoma kinase (ALK) mutation-positive (ALK+) non-small cell lung cancer (NSCLC) patients are sensitive to pemetrexed. To determine its efficacy, we retrospectively evaluated clinical outcomes of pemetrexed-based chemotherapy in patients with ALK+ NSCLC. MATERIALS AND METHODS: We identified 126 patients with advanced, ALK+ NSCLC who received first-line cytotoxic chemotherapy. We compared response, progression-free survival (PFS), and overall survival (OS) rates according to chemotherapy regimens. Furthermore, we evaluated intracranial time to tumor progression (TTP) and proportion of ALK+ cells as prognostic factors. RESULTS: Forty-eight patients received pemetrexed-based chemotherapy, while 78 received other regimens as first-line treatment. The pemetrexed-based chemotherapy group showed superior overall response (44.7% vs. 14.3%, p < 0.001) and disease control (85.1% vs. 62.3%, p=0.008) rates. The pemetrexed-based chemotherapy group also exhibited longer PFS (6.6 months vs. 3.8 months, p < 0.001); OS rates were not significantly different. The lack of exposure to second-generation ALK inhibitors and intracranial metastasis on initial diagnosis were independent negative prognostic factors of OS. Intracranial TTP was similar between the treatment groups (32.7 months vs. 35.7 months, p=0.733). Patients who harbored a greater number of ALK+ tumor cells (≥70%) showed prolonged OS on univariate analysis (not reached vs. 44.8 months, p=0.041), but not on multivariate analysis (hazard ratio: 0.19, 95% confidence interval: 0.03–1.42; p=0.106). CONCLUSION: Pemetrexed-based regimens may prolong PFS in patients with ALK+ NSCLC as a first-line treatment, but are not associated with prolonged OS. Exposure to second-generation ALK inhibitors may improve OS rates in patients with ALK+ NSCLC.
Adult ; Aged ; Antineoplastic Agents/*therapeutic use ; Carcinoma, Non-Small-Cell Lung/*drug therapy/enzymology/mortality ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms/*drug therapy/enzymology/mortality ; Male ; Middle Aged ; Mutation ; Pemetrexed/*therapeutic use ; Receptor Protein-Tyrosine Kinases/genetics ; Retrospective Studies ; Survival Rate ; Treatment Outcome