PURPOSE: The colonoscopic polypectomy has become a valuable procedure for removing precursors of colorectal cancer, but some complications can be occurred. The most common complication after colonoscopic polypectomy is bleeding, which is reported to range from 1% to 6% and which can be immediate or delayed. Because the management of delayed postpolypectomy bleeding could be difficult, the use of preventive technique and reductions of risk factors are essential. METHODS: From January 2007 to December 2008, delayed hemorrhage occurred in 18 of the 1,841 polypectomy patients examined by one endoscopist. These cases were reviewed retrospectively for risk factors, pathologic findings, and treatment methods. RESULTS: Delayed bleeding occurred in 18/1,841 patients (0.95%). The mean age was 55.9 +/- 10.9 years, and the male-to-female ratio was 8:1. The most common site was the right colon (11 cases, 61.1%), and the average polyp size was 9.2 +/- 2.8 mm. Delayed bleeding was identified from 1 to 5 days after resection (mean, 1.6 +/- 1.2 days). The most common macroscopic type of polyp was a sessile polyp (10 cases, 55.6%), and histologic finding was a tubular adenoma in 13 cases (72.2%). Seventeen cases were treated with clipping for hemostasis and 1 case with epinephrine injection. CONCLUSION: The right colon and a sessile polyp were associated with an increase in delayed postpolypectomy bleeding. Reducing risk factors and close observation were essential in high risk patients, and prompt management with hemoclips was effective.
Adenoma ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Epinephrine ; Hemorrhage ; Hemostasis ; Humans ; Polyps ; Retrospective Studies ; Risk Factors

PURPOSE: The anal verge is the border of the lowest part of the anal canal. However, grossly, it may be difficult to identify. Therefore, to assess the precise position of the anal verge, we performed this study. METHODS: From August 1 to 31, 2006, 40 patients having anal surgery under spinal anesthesia were selected randomly. Prior to surgery, the anal verge was marked with the patient in the Sims's position. After marking, the anus was pulled bilaterally to both sides using bandages, and the lengths of the four areas were measured with the patient in the jackknife position. RESULTS: With the patient in the jackknife position, the anal verge was moved laterally by an average of 1.09+/-0.36 cm. The shift distance of the anal verge relative to the anal area was measured; the shift distance in the posterior direction was 1.1+/-0.30 cm, that in the anterior direction was 0.85+/-0.25 cm, that in the right lateral direction was 1.22+/-0.41 cm, and that in the left lateral direction was 1.20+/-0.34 cm. The shifted distance to the posterior area was significantly longer than that to the anterior area (P<0.05). CONCLUSION: When performing anal surgery with the patient in the jackknife position, the anal verge is shifted to the lateral side of the anus compared to its position when the patient is in the normal position. Notably, the shift distance to the posterior area was significantly longer than that to the anterior area. By assessing the precise position of the anal verge, the surgeon can reduce the resection range of the anoderm and create an appropriate drainage wound.
Anal Canal ; Anesthesia, Spinal ; Bandages ; Drainage ; Humans

No abstract available.
Colonic Neoplasms ; Pneumothorax

No abstract available.
Abscess ; Lymphoma ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Muscle, Skeletal

PURPOSE: This study investigated the correlative relationship between metabolic parameters estimated from dual time point 2-deoxy-2-[¹⁸F] fluoro-D-glucose (¹⁸F-FDG) positron emission tomography/computerized tomography (PET/CT) and the clinical tools predicting the outcome of a lymphoma. We also measured metabolic and volumetric alterations between early and delayed ¹⁸F-FDG PET/CT in patients with high grade lymphoma (HGL).METHODS: The samples were 122 lymph nodes and extralymphatic lesions from 26 patients diagnosed with HGL. All patients were applied to the International Prognostic Index (IPI), Ann Arbor stage, and revised IPI as clinical prognostic parameters. ¹⁸F-FDG dual time point PET/ CT (DTPFP) consisted of an early scan 1 h after ¹⁸F-FDG injection and a delayed scan 2 h after the early scan. Based on an analysis of DTPFP, we estimated the standardized uptake value (SUV) of tumors from the early and delayed scans, retention index (RI) representing the percentage change between early and delayed SUV, and metabolic volume different index (MVDI) calculated using metabolic tumor volumes (MTV).RESULTS: RI(max) showed a multiple positive correlative relationship with stage and IPI in lesion-by-lesion analysis (p < 0.01). In the case of IPI, the high risk group exhibited higher RI(max) than the low risk group (p = 0.004). In the case of revised IPI, the RI(max) of the low risk group were significantly lower than the intermediate and high risk groups, respectively (p < 0.01). The MVDIs of the best outcome group were decreased in comparison to the moderate outcome group (p = 0.029). There was a significant negative correlative relationship between RI(max) and MVDI, and the inclinations for decreased MVDIs were slightly associated with increased RIs.CONCLUSIONS: RI(max) extracted from DTPFP had a significant relationship to extranodal involvement, staging, IPI, and revised IPI. MVDI showed significant negative correlation with RI(max). Further large scale studies are warranted to support and extend these preliminary results.
Electrons ; Humans ; Lymph Nodes ; Lymphoma ; Pilot Projects ; Positron-Emission Tomography and Computed Tomography

No abstract available.
Carcinoma, Renal Cell* ; Drug Therapy* ; Humans

No abstract available.
Acanthosis Nigricans/diagnosis/*etiology ; Biopsy ; Gastrointestinal Stromal Tumors/chemistry/*complications/pathology ; Humans ; Immunohistochemistry ; Laparoscopy ; Male ; Middle Aged ; Paraneoplastic Syndromes/diagnosis/*etiology ; Peritoneal Neoplasms/chemistry/*complications/pathology ; Proto-Oncogene Proteins c-kit/analysis ; Tomography, X-Ray Computed ; Tumor Markers, Biological/analysis

BACKGROUND AND OBJECTIVES: The growth of tumor is dependent on angiogenesis. Expressions of vascular endothelial growth factor (VEGF) as a prognostic indicator has been documented for various types of human tumors. The purpose of this study was to investigate the relationship between the expression of VEGF and the differentiation and TNM stage of the laryngeal squamous cell carcinoma. MATERIALS AND METHOD: The VEGF expression was evaluated by immunohistochemical staining with monoclonal anti-VEGF antibody in 28 cases of the laryngeal squamous cell carcinoma. RESULTS: The positive staining for VEGF was observed in 5 (31.3%) out of 16 cases of well differentiated carcinomas and 7 (58.3%) out of 12 cases of moderately differentiated carcinomas. Comparing with the TNM staging system, no positive staining was found in any of the stage I cases; however, 2 out of 6 cases (33.3%) of stage II, 3 out of 7 cases (42.9%) of stage III and 6 out of 9 cases (66.7%) of stage IV showed positive staining for VEGF. There was statistical relationship between the differentiation and positive expression for VEGF, but not between the stage of the laryngeal squamous cell carcinoma and the VEGF expression. CONCLUSION: These results suggest that there is a clinical correlation of VEGF expression to the progress of differentiation and tumor stages.
Angiogenesis Inducing Agents ; Carcinoma, Squamous Cell* ; Humans ; Larynx ; Neoplasm Staging ; Vascular Endothelial Growth Factor A*

Superior vena cava syndrome (SVCS) is usually caused by extrinsic compression or invasion of the superior vena cava (SVC) by malignant tumors involving mediastinal structures. Although thymomas are well-known causes of SVCS, cases of SVCS caused by malignant thymomas protruding into adjacent vessels draining the SVC with thrombosis have been very rarely reported worldwide. We experienced a 39-year-old female patient with SVCS that developed after the direct invasion of the left brachiocephalic vein (LBCV) and SVC by an anterior mediastinal mass with a high maximum standardized uptake value on the chest computed tomography (CT) and positron emission tomography-CT. Based on these results, she underwent en bloc resection of the tumor, including removal of the involved vessels, and was eventually diagnosed as having a type B2 thymoma permeating into the LBCV and SVC. We present this case as a very rare form of SVCS caused by an invasive thymoma.
Adult ; Brachiocephalic Veins ; Electrons ; Female ; Humans ; Positron-Emission Tomography ; Superior Vena Cava Syndrome* ; Thorax ; Thrombosis ; Thymoma* ; Vena Cava, Superior*