No abstract available.
Breast Feeding* ; Breast Neoplasms* ; Breast* ; Case-Control Studies* ; Female ; Humans ; Korea*

Primary extrapulmonary small cell carcinoma (EPSCC) of the appendix is an extremely rare entity, and there has been only one previous report on this in the English medical literature. We report here on the first Korean case of EPSCC of the appendix in a 55-year-old woman. The patient had no history of an identified pulmonary tumor, and she presented with constipation and lower abdominal pain. The patient underwent right hemicolectomy with regional lymph node dissection and bilateral salphigo-oophorectomy. The histology of the entire appendiceal tumor revealed pure EPSCC with diffuse immunoreactivity for pancytokeratin, cytokeratin 7, cytokeratin 20, CD56, thyroid transcription factor 1, c-kit and carcinoembryonic antigen, and there was focal weak immunoreactivity for chromogranin A and synaptophysin. After the second cycle of chemotherapy, the condition of the patient gradually deteriorated due to cancer peritonei and the patient died 7 months later. EPSCC of the appendix is a distinctive clinicopathological entity that displays highly aggressive behavior and an unfavorable outcome.
Abdominal Pain ; Appendix ; Carcinoembryonic Antigen ; Carcinoma, Small Cell ; Chromogranin A ; Constipation ; Female ; Humans ; Keratin-20 ; Keratin-7 ; Lymph Node Excision ; Middle Aged ; Nuclear Proteins ; Synaptophysin ; Thyroid Gland ; Transcription Factors

PURPOSE: Single-port laparoscopic surgery is a rapidly advancing technique in laparoscopic surgery. However, there is currently limited evidence on the learning curve for this procedure. The aim of this study was to estimate the number of single port laparoscopic cholecystectomies required until improvement in the performance of the technique ceases. METHODS: This is a descriptive, single-center study using routinely collected clinical data from 70 patients who underwent single port laparoscopic cholecystectomy between May 2009 and June 2010 at Dong-A University Medical Center in Busan, Korea. The review includes the mean operating time, conversion cases, intra-operative GB perforation, post-operative wound infection and mean hospital stay. RESULTS: The mean operating time of the first 30 cases (the learning period) was 91.83 minutes. After 30 operations (the experience period), it plateaued to an average of 75.25 minutes, which remained steady in the next 40 operations - a reduction of more than 16%. Reduction in the operating time was significant (P<0.001) between the learning period and the experience period. Other factors including additional ports, intraoperative gall bladder perforation, mean hospital stay, post-operative wound infection were not significantly different between the two periods. CONCLUSION: We suggest that the learning curve for single port laparoscopic cholecystectomy should be around thirty cases for a surgeon with prior conventional laparoscopic cholecystectomy experience and for self-taught single port technique.
Academic Medical Centers ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Humans ; Korea ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Urinary Bladder ; Wound Infection

Hang-loose technique(HLT) is a reliable recession method in strabismus surgery. However, the loop length and the parallel of the anterior muscle border may not be sustained when the muscle was recessed behing the equator. This study was designed to assess the postoperative status of the large-recessed superior rectus muscle using the HLT and a modification of HLT(M-HLT) respectively in rabbits. Some of the recessed muscles with both techniques showed forward creeping. The average creeping was 0.5 mm on M-HLT and 1.1 mm on HLT in 7 mm recession group, and the difference was statistically significant(p=0.023). In 8 mm recession group, the average creeping was 1.0 mm on M-HLT and 1.8 mm on HLT. The difference was statistically significant(p=0.012). Although the parallel of the anterior muscle border was better on HLT than on M-HLT, the difference was not significant statistically. According to our result, M-HLT may be an useful alternative method in the cases of large recession with HLT.
Muscles ; Rabbits* ; Strabismus

No abstract available.
Extremities* ; Sarcoma*

Benzene and toluene, which are widely used aromatic hydrocarbons in workplace, are recently proved to cause health hazards due to their toxic effects. This study investigated the influence of toluene on the urinary excretion of benzene metabolite by administering short term exposure limit(STEL) of these compounds(i.e., 13.8mg/kg of benzene and 108.8mg/kg of toluene) intraperitoneally into Sprague-Dawley rats. After administration, urinary phenol concentration of rat was measured by gas chromatography for every three hours. Data were analyzed by non-parametric statistical methods using Kruskal-Wallis multi-sample test and Mann-Whitney U test. The following results were obtained: 1. Administration of STFL-benzene increased urinary phenol concentration in rats. 2. Urinary phenol concentration was increased logarithmically according to the dosage of benzene. 3. Excretion of phenol in urine was decreased when benzene and toluene were administered simultaneously compared with administering benzene alone. In Summary, these results reveal that administration of STEL of toluene has antagonistic effect of urinary excretion of benzene metabolite in rats.
Animals ; Benzene* ; Chromatography, Gas ; Hydrocarbons, Aromatic ; Metabolism* ; Phenol ; Rats* ; Rats, Sprague-Dawley ; Threshold Limit Values ; Toluene

The use and application of a laparoscopic cholecystectomy has been regarded as a first-choice treatment option for benign gallbladder disease, even if patients have situs inversus totalis. Furthermore, surgical procedures in general are becoming less invasive, because of both patient and surgeon preferences for reduced trauma and improved cosmetic outcomes attributable to minimized incisions. A 37 years old man was aware of situs inversus totalis with chronic cholecystitis. The operation was successfully performed without any specific complications. Single port laparoscopic cholecystectomy, in an experienced operator, is possible even in patients with situs inversus totalis.
Cholecystectomy, Laparoscopic ; Cholecystitis ; Gallbladder Diseases ; Humans ; Situs Inversus

PURPOSE: The variety of outcomes in patients with stage II colorectal carcinomas might be due to understaging caused by an inadequate number of lymph nodes (LNs) being examined. The aim of this study was to determine if any number of examined LNs reflects a reliable node-negative staging for colorectal carcinomas (CRCs). METHODS: Data on 241 patients (132 males) who underwent potentially curative resections for pT3 and pT4 CRC were reviewed. The patients ranged in age from 21 to 87 (mean: 58.2) years with a median follow-up of 43 (range: 7~96) months. The relationship between the number of LNs harvested and both the 5-year disease-free survival (DFS) and the overall survival (OS) rates were assessed for stage II CRCs. RESULTS: A median of 15 LNs (range: 3~104) was harvested per tumor specimen, and lymph-node metastases were present in 107 cases (44.4%). The proportion of lymph-node metastases increased as a function of the number of LNs harvested (P=0.0002; 95% confidence interval, 0.3333~0.8138). The number of LNs revealed to be the best number for dividing stage II patients into subgroups with different DFS and OS rates was ten. The 5-year DFS and OS rates of the 48 patients (35.8%) with nine or fewer LNs harvested were 68.6% and 76.8%, respectively, whereas those of the 86 patients (64.2%) with ten or more LNs harvested were 87.2% and 91.9%, respectively (DFS, P=0.0082; OS, P=0.0303). Moreover, there were no statistical differences between the node-negative patients with nine or fewer LNs harvested and the 67 stage III patients with N1 in respect to the DFS (68.6% vs. 56.7%; P= 0.2031) and the OS (76.8% vs. 68.3%; P=0.2772) rates. CONCLUSIONS: This study suggests that examining a greater number of lymph nodes increases the likelihood of accurate nodal staging and that a minimum of ten LNs per surgical specimen should be harvested and examined to label a pT3 or pT4 CRC as node-negative.
Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Lymph Nodes* ; Neoplasm Metastasis ; Prognosis

Solid pseudopapillary pancreatic neoplasms are rare. The male-to-female ratio is 1:9, and metastasis occurs only in a few cases. A 39-year-old male with a solid pseudopapillary neoplasm (SPN) with lymph node metastasis underwent ultrasonography, CT, and MRI, which revealed a mass (8 cm) in the pancreatic head. Fluorodeoxyglucose (FDG)-PET showed a hypermetabolic lymph node in the root area of the superior mesenteric artery (SMA). The patient underwent pylorus-preserving pancreaticoduodenectomy, which confirmed a peripancreatic lymph node metastasis. The lymph node of the SMA root area remained because of the encasing of the superior mesenteric artery. After 14 months of follow-up (with no adjuvant therapy initiated), the residual metastatic lymph nodes showed no change and no recurrence. In conclusion, surgery of the primary tumor for patients with SPN is recommended, even in cases with metastatic lymph nodes remaining.

The purpose of this study is to evaluate retrospectively the surgical results and complications in the patients with unilateral superior oblique palsy using superior oblique plication(SO plication) only or SO plication combined with inferior oblique weakening. Among 22 patients with unilateral superior oblique palsy, there were 13 patients(59.1%) in type III, 5 patients(22.7%) in type IV, 2 patients(9.1%) in type II and 2 patients(9.1%) in type V according to Knapps classification. The mean amount of hypertropia was 18 prism diopters(PD) and 18 of 22 patients(81.8%) showed abnormal head posture(AHP). Nineteen patients (86.4%) showed horizontal strabismus and exotropia was most common. The methods of oblique and vertical rectus operation were SO plication, SO plication combined with inferior oblique weakening, combined with resection of inferior rectus, and combined with recession of contralateral inferior rectus, inferior oblique weakening, and superior rectus weakening. We performed corrective surgery on the patients with horizontal deviation more than 14 PD. Postoperatively the mean amount of hypertropia was 2.6PD. In 7 patients with superior oblique plication only the mean amount of correction in plication was 8.4PD, and hypertropia was corrected 1.2PD per mm. Thirteen of 18 patients(72.2%) with AHP and 15 of 19 patients (78.9%) with horizontal strabismus were corrected after operation. Postoperative complications were residual hypertropia in 7 patients(31.8%) and Brown syndrome in one. We conclude that plication of the superior oblique may be one of the effective procedures for correction of superior oblique palsy and possible its complications may be postoperative undercorrection and Brown syndrom.
Classification ; Exotropia ; Head ; Humans ; Paralysis ; Postoperative Complications ; Retrospective Studies ; Strabismus