No abstract available.
Humans ; Intestinal Obstruction*

No abstract available.
Insulin-Like Growth Factor Binding Proteins* ; Kidney Failure, Chronic*

No abstract available.
Ear*

We report an autopsy case of the brain stem glioma that extended extensively in the brain stem itself and cephalad. This 18-year-old boy first presented with dizziness, vomiting and left side weakness with left facial palsy. Brain MRI revealed a diffusely infiltrative tumor involving whole medulla, pons and lower midbrain. A total of 4000 R was given with some alleviation of respiratory difficulty. He died one year after the onset. Autopsy revealed the tumor involving pons, a portion of medulla oblongata, and cerebellum. The tumor showed diffusely infiltrative pattern and extended along the periventricular area to the thalamus and corpus callosum. The cut surface was grayish white and solid. It also showed areas of myxoid degeneration and necrosis probably related to radiation therapy. Microscopically the tumor was a cellular and pleomorphic glioma that showed some astrocytic differentiation. It was diffuse without geographic necrosis.

PURPOSE: This study was done to evaluate the differences in clinical parameters and survival rates between the primary tumor (T) and nodal involvement (N) in stage II cancers. METHODS: This report is a retrospective clinical analysis of 100 patients of stage II gastric cancer who were treated surgically at the Department of Surgery, Chonbuk National University Hospital from Jan. 1990 to Dec. 1999. Among the 100 patients, the pT3N0 group included 48 patients, and the pT2N1 group 52 patients. In this study, we used the UICC TNM staging system (the fourth edition). RESULTS: There were no significant differences except for age and tumor sizes between the pT3N0 and the pT2N1 groups with regard to the mode of presentation, sex, location of tumor, type of resection, lymph node dissection, Borrmann and Lauren classification, cell cytology, recurrence, number of resected lymph nodes, and the 5-year survival rate. Based on the number of lymph nodal metastases, no significant difference was observed in the 5-year survival rate, but based on the ratio of lymph nodal metastases, the 5-year survival rate for those with up to 20% frequency of metastases was 85.2% and the 5-year survival rate for those with greater than 20% was 40.0%, which is significant difference in the 5-year survival rate. CONCLUSION: In stage II gastric cancer, there was no difference between the pT3N0 and the pT2N1 group, except that in the pT2N1 group, a subdivision of the pN stage according to the ratio of lymph nodal metastases could be successfully applied to the clinical evaluation of stage II gastric cancer.
Classification ; Humans ; Jeollabuk-do ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate

No abstract available.
Ameloblastoma*

PURPOSE: The technique of anastomosis for gastroduodenostomy is thought to be of importance to success in the postoperative period and to the development of certain complications. Most surgeons a use two-layer anastomosis method. However, interest in single-layer anastomosis has increased. Therefore, we investigated the differences between single-layer and two-layer methods for anastomosis by comparing clinicopathological parameters and clinical courses. METHODS: This report is a retrospective clinical analysis of 265 patients of gastric cancer who underwent gastroduodenostomy following distal gastrectomy at the Department of Surgery, Chonbuk National University Hospital from Jan. 1991 to Dec. 1999. RESULTS: There was no significant difference observed between the two groups with regard to the mode of presentation, mean age, sex, or pathological characteristics of the tumor. The time for the anastomosis was shorter in the single-layer group (30.1+/-1.0 vs 37.1+/-2.1 minutes, p<0.001), the time of gas out was earlier in the single-layer group (4.4+/-1.1 vs 4.7+/-1.2 days, p=0.027) and the time of food intake was earlier in the single-layer group (5.7+/-0.8 vs 6.3+/-1.4 days, p<0.001) than in the two-layer group. Although the complication rate was not significantly different between the two groups, anastomotic leak was observed in 4 cases (2.7%) of the single-layer group and 3 cases (2.6%) of the two-layer group, and passage disorders were observed in 4 cases (2.7%) of the single-layer group and 5 cases (4.3%) of the two-layer group. CONCLUSION: A gastrodudenostomy using the single-layer anastomosis method has an advantage over the two-layer method for anastomosis with respect to the time for anastomosis, the time of gas out and time of food intake. Therefore the single-layer anastomosis method can be effectively employed in gastric cancer surgery.
Anastomotic Leak ; Eating ; Gastrectomy* ; Humans ; Jeollabuk-do ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms*

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Neuroma*

Peritoneal carcinomatosis is a common cause of noncurability and the most common type of recurrence in surgical operations for gastric cancer. Activated carbon particles are taken up selectively by lymphatic tissues, which seem to be a primary site of peritoneal carcinomatosis in the peritoneal cavity, and adsorb a large amount of anticancer agent, such as mitomycin C, which is subsequently released slowly and for long periods. We carried out a retrospective study to determine if activated carbon particles adsorbing mitomycinC ( MMC-CH ) could improve the survival of patients who underwent radical resection for gastric cancer with serosal invasion and peritoneal dissemination and to evaluate the prognostic factors in patients receiving intraperitoneal MMC-CH therapy from January 1993 to January 1996. Those in the control group received no intraperitoneal chemotherapy and those in the MMC-CH group were given 50mg mitomycinC as MMC-CH before the surgical wound closure into the peritoneal cavity. The 3-year survival rates for the MMC-CH group in the case of S2 were 55%, and 17% in the case of S3. But the 3-year survival rate for the control group in the case of S2 was 32% and there was no survivor in S3 cases. In the cases of peritoneal dissemination, there were no survivor for the control group, but the 3-year survival rate for the MMC-CH group was 13%. The difference between the two groups was not statistically significant except positive papanicolaou smear and S3 cases at 3-year survival rates. There was a significant difference in morbidity after surgery between these two groups especially due to fever & hypotension and anastomotic leakage. Multivariative analysis using simple regression model in MMC-CH group has confirmed that the serosal invasion, positive Pap. smear and high stage had a significant impact on the survival rate after gastric resection. In conclusion, intraperitoneal chemotherapy with MMC-CH is effective in prolonging the survival time by prophylatic effect on peritoneal recurrence after curative resection of gastric cancer without significant complication and especially indicated in the cases of positive serosal invasion, positive Pap. smear in peritoneal cytology and high stage.
Anastomotic Leak ; Carbon* ; Carcinoma ; Drug Therapy* ; Fever ; Humans ; Hypotension ; Lymphoid Tissue ; Mitomycin* ; Papanicolaou Test ; Peritoneal Cavity ; Prognosis* ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate ; Survivors ; Wounds and Injuries

PURPOSE: The most feared complication of gastrointestinal tract operations is anastomotic leakage, not only because of the presumed individual surgeon's culpability but also because of the assumption that this event is often fatal. We have experienced 32 cases of anastomotic leakage after elective gastric resection during 8 years. The purpose of this study was to evaluate the result of their treatment. MATERIALS AND METHODS: We evaluated the records of 1335 patients who had undergone elective gastric resection for an adenocarcinoma of stomach from January 1995 to October 2003 and conducted a retrospective, multivariate analysis. RESULTS: Of the 1335 patients, 32 (2.4%) sustained an anastomotic leakage. Anastomotic leakages usually developed on mean postoperative day 9.1+/-3.2 (range:1~18 days). Overall, 31.3% (10/32) of patients who sustained an anastomotic leakage died. The anastomotic leakages were identifed by radiological study or by operative finding at the site of the duodenal stump (20 patients), the esophagojejunostomy (7), the gastroduodenostomy (4), and the gastrojejunostomy (1). Fourteen patients (43.8%) underwent a relaparotomy, a drainage procedure in the main, and 18 patients (56.3%) were treated conservatively. The mortality rates were 42.9% (6/14) and 22.2% (4/18), respectively, but this difference was not statistically significant. A cox's proportional hazard analysis showed that a body-mass Index < 24 kg/m2 (odds ratio 5.55, 95% CI: 0.69~44.82) and non-enteral feeding (odds ratio 18.27, 95% CI 2.22~150.69) were independent factors of mortality due to anastomotic leakage. CONCLUSION: Our observations show that anastomotic leakage after an elective gastric resection has a high risk of being fatal. Moreover, for a patient with a body-mass index lower than 24 kg/m2 and/or non-enteral feeding, an anastomotic leakage after an elective gastric resection has a higher risk of being fatal.
Adenocarcinoma* ; Anastomotic Leak* ; Drainage ; Enteral Nutrition ; Gastrectomy* ; Gastric Bypass ; Gastrointestinal Tract ; Humans ; Mortality ; Multivariate Analysis ; Retrospective Studies ; Stomach ; Stomach Neoplasms