In this retrospective study, 49 patients who were treated by surgical resection of colorectal cancer, confuted to proper muscle and confirmed histologically from 1979 to 1996 were included. To examine the significance of growth pattern in terms of polypoid growth(PG)(n=26; m,sm 5, pm 21) and non-polypoid growth(NPG)(n=23; m,sm 3, pm 20), we analyzed several clinocopathologic variables by x2 test and unpaired t-test, 5-year survival rate by Kaplan-Meier method and Log-Rank statistics according to growth type comparatively: 1) In the PG tumor, muscle elevation(P<0.0117) and association with adenoma(P<0.0001) were more frequent than in the NPG. 2) The NPG type showed smaller size(P<0.0172) and higher rate of lymph node metastasis(P=0.025) and higher tendency of lymphatic invasion(P=0.07) and poor differentiation(P=0.0693) and deeper invasion(P=0.0972) and worse 5-year survival(P=0.0607). 3) Otherwise there was no difference in inflammation, fibrosis, and angioinvasion. 4) The mean thickness of Outer Longitudinal Muscle(OLM) was thicker in rectum than colon(rectum 1.62 mm, colon 0.74 mm, p<0.0059) and pm cancer was more in rectum than in colon(rectum 10.3%, colon 4.0% , p=0.0057). In the view of results, NPG in early colorectal cancer may suggest the possibility of de novo cancer. NPG type was smaller in the size but more aggressive in lymph node metastasis, lymphatic invasion, invasion depth, tumor differentiation, 5-year survival rate. So it needs more thorough follow up. The higher incidence of pm cancer in rectum than in colon, is probably due to thicker OLM of rectum than that of colon.
Colon ; Colorectal Neoplasms* ; Fibrosis ; Follow-Up Studies ; Humans ; Incidence ; Inflammation ; Lymph Nodes ; Lymphatic Metastasis ; Rectum ; Retrospective Studies ; Survival Rate

This study attempted to assess the risk factors for mortality of very-low-birth-weight (VLBW) infants in the neonatal intensive care unit (NICU, n=2,386). Using data from the Korean Neonatal Network, we investigated infants with birth weights <1,500 g and gestational ages (GAs) of 22-31 weeks born between January 2013 and June 2014. Cases were defined as death at NICU discharge. Controls were randomly selected from live VLBW infants and frequency matched to case subjects by GA. Relevant variables were compared between the cases (n=236) and controls (n=236) by Cox proportional hazards regression to determine their associations with cause-specific mortality (cardiorespiratory, neurologic, infection, gastrointestinal, and others). In a Cox regression analysis, cardiorespiratory death were associated with a foreign mother (hazard ratio, HR, 4.33; 95% confidence interval, CI, 2.08-9.02), multiple gestation (HR, 1.65; 95% CI, 1.07-2.54), small for gestational age (HR, 2.06; 95% CI, 1.25-3.41), male gender (HR, 1.69; 95% CI, 1.10-2.60), Apgar score < or =3 at 5 min (HR, 1.97; 95% CI, 1.18-3.31), and delivery room resuscitation (HR, 2.60; 95% CI, 1.53-4.40). An Apgar score < or =3 at 5 min was also associated with neurological death (HR, 2.95; 95% CI, 1.29-6.73). Death due to neonatal infection was associated with outborn delivery (HR, 5.09; 95% CI, 1.46-17.74). Antenatal steroid and preterm premature rupture of membranes reduced risk of cardiorespiratory death (HR, 0.43; 95% CI, 0.27-0.67) and gastrointestinal death (HR, 0.30; 95% CI, 0.13-0.70), respectively. In conclusion, foreign mother, multiple gestation, small gestation age, male gender, Apgar score < or =3 at 5 min, and resuscitation in the delivery room are associated with cardiorespiratory mortality of VLBW infants in NICU. An Apgar score < or =3 at 5 min and outborn status are associated with neurological and infection mortality, respectively.
Apgar Score ; Cohort Studies ; Databases, Factual ; Female ; Gestational Age ; Humans ; Infant ; *Infant Death ; *Infant Mortality/trends ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care Units, Neonatal ; Kaplan-Meier Estimate ; Male ; Pregnancy ; Pregnancy, Multiple ; Proportional Hazards Models ; Republic of Korea ; Resuscitation ; Risk Factors ; Sex Factors

INTRODUCTION: There was increase in a fall injury at the field of construction work, nowadays. There was also increase in penetrating injury by an iron reinforcing bar associated with a fall or slip injury. But this is not widely discussed in the surgical literature. The purpose of this study was to define the characteristics of injury, diagnosis, treatment and prognosis of the penetrating injury by an iron reinforcing bar associated with a fall or slip injury. METHODS AND MATERIALS: We reviewed retrospectively medical records of 17 patients who admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating injury by an iron reinforcing bar associated with a fall or slip injury from Nov. 1987 to Dec. 1996. RESULTS: The penetrating injuries by an iron reinforcing bar associated with a fall or slip injury were 5 cases of a slip injury and 12 cases of a fall injury. The insertion site of an iron reinforcing bar was perineum in all of a slip injury. In a fall injury, insertion site was flank and back in 5 cases, perineum 4 cases, chest 2 cases and abdomen 1 case. In a fall injury, 9 patients had two or more organ injuries. CT scan was taken in 3 cases, sigmoidoscopy 3 cases and fistulogram 1 case in a slip injury. CT scan was done in 5 cases, sigmoidoscopy 1 case, cystogram 2 cases and intravenous pyelogram 1 case in a fall injury. 2 cases was cured conservatively, and operation was done in 3 cases in a slip injury in contrast to 2 cases of conservative management and operation 10 cases in a fall injury. There was no negative celiotomy. Complication was only one wound infection in a slip injury. There were wound infection 6 cases, pulmonary complication 4 cases, sepsis 1 case, necrotizing fascitis 1 case, anal sphincter injury 1 case, intraabdominal abscess 1 case and neurogenic bladder 1 case in a fall injury. There was no mortality. CONCLUSION: The penetrating injuries by an iron reinforcing bar associated with a fall or slip injury had characteristics of both penetrating and blunt injury. The chest and abdominal penetrating injuries lead to multiple organ injury. In perineal penetrating injury, we should evaluate the injury of urinary bladder, rectum and genital organ.
Abdomen ; Abscess ; Anal Canal ; Diagnosis ; Fasciitis, Necrotizing ; Genitalia ; Humans ; Iron* ; Medical Records ; Mortality ; Perineum ; Prognosis ; Rectum ; Retrospective Studies ; Sepsis ; Sigmoidoscopy ; Thorax ; Tomography, X-Ray Computed ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Wound Infection ; Wounds, Nonpenetrating

Objectives: To determine the clinical characteristics of Korean patients with sporadic oculopharyngodistal myopathy. Methods: Three consecutive unrelated Korean patients with sporadic oculopharyngodistal myopathy participated in this study. Stepwise approaches were performed including careful clinical examination, electrophysiological study, pathology evaluation and genetic study. The literature on oculopharyngodistal myopathy was reviewed. Results: Clinically, our patients showed consistent features of initial distal limb weakness with variable ophthalmoplegia, bulbar weakness or proximal weakness. All the patients showed rimmed vacuoles and myopathic changes. Conclusion: Through the literature review and this study, we believe that initial distal limb weakness is a characteristic fi nding in patients with oculopharyngodistal myopathy in some ethnic groups.

A retrospective analysis of the ultrasonographic findings of 9 cases of tuberculous abscess, 5 cases of pyogenic abscess and 2 cases of hematoma of psoas and adjacent muscles was made. Fluid collection with or without internal echoes was seen in 12 cases out of total 16 cases. Other findings were 2 cases of only muscle swelling, 1 case of highly echogenic mass.like appearance and 1 case of fluid collection with septae. Ultrasonography is considered an accurate method in identifying early pathologic changes of the psoas muscle and determining its extent. and in differentiating tumor from fluid collection of the psoas muscle. Authors dare to say that ultrasound examination is a procedure of choice in the diagnosis of psoas abscess and hematoma.
Abscess ; Diagnosis ; Hematoma ; Methods ; Muscles ; Psoas Abscess ; Psoas Muscles ; Retrospective Studies ; Ultrasonography

Eighteen cases of osteonecrosis of the femoral head associated with macromolecular polyvinylpyrrolidone (PVP) deposition were analysed on the basis of clinical, radiologic and pathologic features. The cases were observed during 8 years period from January, 1974 to December, 1981. The pathogenesis of the osteonecrosis of the femoral head due to PVP storage in reticuloendothelial system were discussed in detail. Parenteral administration of high-molecular PVP in repeated, long duration led to osteonecrosis of the femoral head. Storage of PVP in the histiocytes of the bone marrow resulted in osteonecrosis of the femoral head followed by microciculation disturbance. PVP-induced osteonecrosis were manifested as multiple foci of necrosis involving not only the femoral head, other long bones around joints, but also the visceral reticuloendo-thelial system characterized by infiltrates of histiocytes laden with PVP. The patients with PVP induced osteonecrosis complianed multiple joint pain in their early course of the disease. On roentgenogram, osteonecrosis were often noted in the hip, shoulder, knee, and ankle in order or frequency. Foamy histiocytes laden with PVP were characteristic on hematoxylin-eosin stain diagnostic on Weigert's elastica, phosphotungstic acid hematoxylin, and Congo red stains. As far as rationale of the treatment concerning a number of staging systems for Osteonecrosis, the choice of surgical procedures were similar to those given by W.F. Enneking et al. In the series, we have performed two hips in total surface replacement, 26 hips in total hip replacement mostly for 3rd generation-configuration of Charnley prosthesis. In addition, one case for free vascularized fibula graft and trans-trochanteric rotational osteotomy after Sugioka were also included for this study. The result of treatment was rather optimistic. However, complications have occured in 4 hips of 3 patients which required removal of whole prosthetic components. Therefore, we underwent revisional surgery in three out of four hips subsequently during the short post-poerative follow-up. These will be published in the future.
Ankle ; Arthralgia ; Arthroplasty, Replacement, Hip ; Bone Marrow ; Coloring Agents ; Congo Red ; Fibula ; Follow-Up Studies ; Head ; Hematoxylin ; Hip ; Histiocytes ; Humans ; Joints ; Knee ; Mononuclear Phagocyte System ; Necrosis ; Osteonecrosis ; Osteotomy ; Phosphotungstic Acid ; Povidone ; Prostheses and Implants ; Rubber ; Shoulder ; Transplants

This report concerns an unusual case of acute postoperative pulmonary edema without any apparent causes in a 45-year-old man. The patient was subjected to the removal of a previously placed device on the left tibia, and the excision of a benign mass on the right forearm. Unexpected acute bilateral pulmonary edema occurred immediately after the completion of the procedures. The etiologies were reviewed in relation to the patient's condition and clinical manifestations. Fluid overloading was excluded as a cause in view of the patient's perioperative state and postoperative chest X-ray results. We could not find any symptoms of upper airway obstruction during emergence from general anesthesia. We had doubts about tourniquet or fentanyl-induced pulmonary edema, but these factors were not sufficient to bring about pulmonary edema in this case. To our knowledge, the cause of acute pulmonary edema in this case is indeterminate.
Airway Obstruction ; Anesthesia, General ; Forearm ; Humans ; Middle Aged ; Pulmonary Edema* ; Thorax ; Tibia ; Tourniquets

A 42-year-old female was admitted with an 11-month history of progressive spastic paraparesis and ataxic gait. Magnetic resonance imaging showed intraspinal space occupying lesion compressing the spinal cord posteriorly, located from C5 to T2 with iso to high signal intensity at T2-weighted images and high signal intensity at T1-weighted images. The patient underwent surgery for decompression of the affected spinal cord because of the progressive neurological deficit. At surgery, the lesion was intradural extramedullary lipoma composed with mature adipose tissue. Partial tumor removal to decompress the neural structures and laminoplasty to avoid postoperative instability and deformity were performed. Postoperatively, she demonstrated improvement in paraparesis and was able to walk without assistance. Though attempts to decrease the size of or even to totally remove a lipoma are not required to achieve satisfactory results and carry considerable risks of surgical morbidity, a careful and limited decompression of the affected spinal cord through a partial removal of the tumor and laminoplasty could result in a significant neurological improvement.
Adipose Tissue ; Adult ; Congenital Abnormalities ; Decompression ; Female ; Gait ; Humans ; Lipoma* ; Magnetic Resonance Imaging ; Paraparesis ; Paraparesis, Spastic ; Spinal Cord

Enterococcus hirae infection is rare in humans. We describe a case of pyelonephritis that was caused by Enterococcus hirae in a 57-year-old woman. E. hirae was isolated from both blood and urine. This is the 2nd case report on bacteremia caused by E. hirae in Korea.
Bacteremia ; Enterococcus ; Female ; Humans ; Korea ; Middle Aged ; Pyelonephritis

Enterococcus hirae infection is rare in humans. We describe a case of pyelonephritis that was caused by Enterococcus hirae in a 57-year-old woman. E. hirae was isolated from both blood and urine. This is the 2nd case report on bacteremia caused by E. hirae in Korea.
Bacteremia ; Enterococcus ; Female ; Humans ; Korea ; Middle Aged ; Pyelonephritis