No abstract available.
Cushing Syndrome*

No abstract available.
External Fixators*

No abstract available in English.
Bone Transplantation ; Electric Stimulation ; Pseudarthrosis ; Tibia

Malformation of the anus and rectum, frequently refered to as imperforate anus are the most common of congenital anomalies among the congenital anomalies of gastrointestinal tract, occuring about once in every 5,000births. They consist of variety of lesions ranging from mild congenital stenosis of the anus which requires simple dilation for cure to complex deformities which present some of the most vexing and discouraging problem in management. This is the report of clinical analysis and evaluation of 67 patients with congenital anorectal malformation, experienced at Severance Hospital, during past 15 years form Jan. 1963 to Dec. 1978. The results of observation were as follows: 1. Incidence of observation were as follows: 2. There were 47 males and 18 females and 2 cases of unknown sex, than male/female ratio was 2.6 : 1. 3. First and second born were more commonly observed than the others. 4. High anomalies were 37.3%, intermediate anomales were 11.9% and low anomalies were 46.3%. 5. Associated anomalies were noted in 12 out of 67 cases, which consist of congenital heart diseases, skeletal anomalies, single umbillical artery, congenital megacolon etc. 6. In general, perineal anoplasty with or without preliminary colostomy were performed in low anomalies and some cases of intermediate anomalies. And abdominoperineal pull-through operation with or without preliminary colostomy were done in high anomales. 7. Complication after surgery were main wound infection ad disruption, intestinal obstruction, fecal incontinence, urinary incontinence, vaginal perforation, and urethral injury etc. 8. Overall mortality was 19.4% and operative mortality was 9.4%. 9. Factors influencing on mortality were congenital heart diseases, sepsis, prematurity, multiple congenital anomalies, respiratory insufficiency, meningomyelocele and tracheoesophageal fistula.
Anal Canal ; Anus, Imperforate ; Arteries ; Colostomy ; Congenital Abnormalities ; Constriction, Pathologic ; Fecal Incontinence ; Female ; Gastrointestinal Tract ; Heart Diseases ; Hirschsprung Disease ; Humans ; Incidence ; Intestinal Obstruction ; Male ; Meningomyelocele ; Mortality ; Rectum ; Respiratory Insufficiency ; Sepsis ; Tracheoesophageal Fistula ; Urinary Incontinence ; Wound Infection

No abstract available.
Adenocarcinoma, Papillary* ; Thyroid Gland*

Intracranial aspergillosis is rare and often fatal, and the brain is the third most frequent origine involved, precede by the lung and the gastrointestinal tract. Two routes of infection are considered important for infection of the central nervous system with aspergillus ; direct spread of infection, mostly within the paranasal sinuses, or hematogenous spread, usually originated from the lung. Paranasal sinus mucocele is a chronic expanding lesion lined by sinus mucosa and containing thickened mucus. Complication arise as a result of infection or expansion of mucoceles. Mucoceles that invade adjacent area, such as the orbits or anterior cranial fossa, can cause complication by a mass effect. The authors report their surgical experience of intracranial aspergillus abscess combined with large frontal mucopycele.
Abscess* ; Aspergillosis ; Aspergillus* ; Brain ; Central Nervous System ; Cranial Fossa, Anterior ; Gastrointestinal Tract ; Lung ; Mucocele ; Mucous Membrane ; Mucus ; Orbit ; Paranasal Sinuses

PURPOSE: Obesity is, along with metabolic syndrome, closely related with nonalcoholic fatty liver disease. This study tried to evaluate the prevalence of nonalcoholic liver disease in obese children and verify the factors associated with the disease. METHODS: Two hundred and seventy nine children who showed a body mass index of 95 percentile over the baseline in health examinations of surrounding schools were evaluated. Questionnaires, body measurements, blood examinations, and ultrasonographic measurements of abdominal fat were examined. RESULTS: Out of 279 children enrolled for the study, 27 children were found to possess nonalcoholic liver disease(9.7%). Among those found to be positive for nonalcoholic liver disease, it's prevalence increased to 15.2%(22 out of 144 children) among children with severe obesity. Factors known to be involved with metabolic syndrome, namely waist/hip circumference ratio and thickness of abdominal fat, were found to be closely related to nonalcoholic fatty liver as well. CONCLUSION: The prevalence of nonalcoholic fatty liver in obese children was 9.7%, with higher incidence observable in severer obesity. Factors responsible for metabolic syndrome were closely associated with nonalcoholic fatty liver disease, and the level of insulin resistance, which is an useful index in both diseases, can be utilized in evaluation of the effect of treatment and control of risk factors.
Abdominal Fat ; Body Mass Index ; Child* ; Fatty Liver* ; Humans ; Incidence ; Insulin Resistance ; Liver ; Liver Diseases ; Obesity ; Obesity, Morbid ; Prevalence* ; Surveys and Questionnaires ; Risk Factors

Thyroid gland is composed of follicles surrounded by basement membrane, which is known to be related to the regenerative processes in several organs. This study was performed to observe the morphological details and changes of the basement membrane components, which are the presumtive factors in thyroid regeneration, with time sequences after partial thyroidectomy and then the relations between the components and thyroid regeneration were confirmed. Thyroid galnds of adult male rats were examined before and 1, 2, 3, 4, 5, 7 and 10 days after bilateral partial[50-60%] thyroidectomy. The basememnt membranes of follicles were prominent with high eosinophilicity at later stage when H & E stained. But in PAS and EM staining, the basement membrane of the operated groups didn`t show any specific changes comparing with control group but the dense collagenous fibers at the interfollicular space outside the membrane. Immunostaining of proliferating cell nuclear antigen[PCNA], which reflects the growth fraction, showed 2.3% positivity of total follicular cells in control group. The PCNA positive ratio in experimental groups were 10.3%, 15.9%, 19.9%, 12.2%, 10.5%, 1.9%, 2.7% on postoperative 1, 2, 3, 4, 5, 7, 10 days respectively. In unilaterally thyroidectomized rats, the resected lobe revealed 18.2% of PCNA positive ratio 3 days after operation, while that in the unresected lobe was only 5.9%. This suggested the predominence of local factors in thyroid regeneration. Meanwhile, with the double immunostaining of calcitonin and PCNA discriminate between follicular cells and C-cells among the PCNA positive cells, PCNA positive C-cells were very rare. The immunostaining of laminin, fibronectin, and collagen IV showed varying intensity with the progress of regeneration. Stainability for collagen IV was maintained in all groups with some increase in 5- and 7-day groups. Laminin was well localized to the basement membrane of the control follicle, and the staining intensity for laminin was markedly increased with additional cytoplasmic staining in follicular cells in 1- to 3-day groups and then decreased to attain the control level in 10-day group. In case of fibronectin, the control follicle showed scarce staining, but the resected group showed strong positivity for fibronectin with the most intense staining in 1- to 3-day groups. Immunostaining for fibronectin still showes in 10-day group with the gradual disappearance of immunoreactivity in the center of the lobe. This study revealed the accompaning changes of the basement membrane components during the regeneration process of partially resected thyroid glands. Among them, collagen IV seems to support the structural integrity of the basement membrane. Laminin and fibronectin were supposed to be related to the thyroid follicular regeneration.
Adult ; Animals ; Basement Membrane ; Calcitonin ; Collagen ; Collagen Type IV ; Cytoplasm ; Eosinophils ; Extracellular Matrix* ; Fibronectins ; Humans ; Laminin ; Male ; Membranes ; Proliferating Cell Nuclear Antigen ; Rats* ; Regeneration ; Thyroid Gland* ; Thyroidectomy

PURPOSE: The aim of this study was to assess the feasibility and safety of laparoscopic multivisceral resection of colorectal cancer adherent to adjacent organs. METHODS: We reviewed retrospectively 32 patients undergoing elective laparoscopic multivisceral resection for colorectal cancer adherent to adjacent organs between June 2003 and May 2009. Survival curves were generated by Kaplan-Meier method. RESULTS: The median age of 32 patients was 73 years. In 10 of 17 rectal cancer patients (59%), neoadjuvant chemoradiation was performed. All the surgeries were completed laparoscopically. The postoperative complications occurred in 21.9% and there was no operative mortality. The median length of hospital stay was 15.5 days. In 23 of 32 patients (72%), the resection was considered curative. Median follow-up period of all patients and curatively resected patients was 22 (range, 2~65) months, 34 (range, 4~65) months respectively. Local recurrence rate, the 3-year overall survival rate and the 3-year disease free survival rate of 23 curatively resected patients was 4.3%, 92.9% and 84.4%, respectively. CONCLUSION: Laparoscopic multivisceral resection is feasible and safe in highly selected patients with colorectal cancer adherent to adjacent organs. Further validation is needed.
Colorectal Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Postoperative Complications ; Rectal Neoplasms ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: To describe modes of transarticular invasion, with reference to the size and location of a tumor, the anatomic characteristics of invaded cartilage, and the existence of ankylosis in SI joint. MATERIALS AND METHODS: Eleven histologically confirmed malignant pelvic bone tumors involving transarticular invasion of sacroiliac joints, were retrospectively analysed. Transarticular invasion of a joint was defined as involvement of its opposing bones. The anatomic site and size of the tumors were analysed, and invaded sacroiliac joint was divided into upper, middle and lower parts on the basis of the anatomic characteristics of the intervening cartilage: synovial hyaline or fibrous ligamentous. The existence of ankylosis was determined, and transarticular invasion directly across a joint was classified as direct invasion. Extension of tumors around a joint from its periphery to the opposing bone were considered as indirect invasion. RESULTS: All tumors were located near the sacroiliac joint, eight at the ilium and three at the sacrum. Six invasions were indirect and five were direct. Average tumor area was larger in indirect cases than in direct: 191.8 cm2 vs. 69.6 cm2. In all indirect invasions, a huge soft tissue mass abutted onto the peripheral portion of the sacroiliac joint. In five of six cases of indirect transarticular invasion, the upper part of the joint posteriorly located fibrous ligamentous cartilage. In the other, the lower part was invaded, and this involved a detour around the joint space, avoiding the invasion of intervening cartilage. Ankylosis occurred in one of the indirect cases. Among the five cases of direct invasion, there was invasion of the posteriorly located ligamentous fibrous cartilage in three without ankylosis. In the other two cases, involving ankylosis, the synovial hyaline cartilage was invaded directly at the lower part of the joint. CONCLUSION: Transarticular invasions of sacroiliac joint via fibrous cartilage are most common. Ankylosis of the sacroiliac joint facilitates hyaline cartilage invasion. We consider that in transarticular invasion of malignant pelvic bone tumors, indirect invasion is more common than direct.
Ankylosis ; Cartilage ; Hyalin ; Hyaline Cartilage ; Ilium ; Joints ; Ligaments ; Pelvic Bones* ; Retrospective Studies ; Sacroiliac Joint* ; Sacrum