No abstract available.
Carcinogenesis* ; Colorectal Neoplasms*

No abstract available.
Colon* ; Lymphangioma, Cystic*

Intussusception can develop at any age but about 95% of patients are children under 2 years-old. Adult intussusception is a rare condition. Unlike children, nearly all adults with intussusception have a lead point such as benign or malignant small bowel tumors, intestinal tuberculosis, or Meckel's diverticulum. First case is a 48-year-old male who was admitted with 2 days of diffuse abdominal cramping pain and no other associated gastrointestinal symptoms. Barium enema revealed ileocolic intussusception with a round cecal mass after barium reduction. An ileocecectomy was performed electively. The pathologic report was cecal cyst, which was an intraluminal structure with an epithelial lining of colonic mucosa. The second case, a 53-year-old male, was admitted with 1 week of diffuse abdominal cramping pain and watery diarrhea. Barium enema revealed ileocecal intussusception. Emergency surgery (ileocecectomy), revealed a polypoid small bowel mass. The pathologic report was lipoma. Recently, we experienced two cases of adult intussusception and report these cases with a brief review of the literature.
Adult* ; Barium ; Child ; Child, Preschool ; Colic ; Colon ; Diarrhea ; Emergencies ; Enema ; Humans ; Intussusception* ; Lipoma ; Male ; Meckel Diverticulum ; Middle Aged ; Mucous Membrane ; Tuberculosis

Cavernous hemangioma in the gastrointestinal tract is a rare benign vascular lesion, which can produce massive or persistent blood loss. Herein, we present two cases of gastrointestinal hemangiomas that could not be resected completely and were treated with estrogen because of multiple involvement of the gastrointestinal tract and viscera, including the anal canal. A 49-year-old male presented with unknown chronic melena and anemia. Preoperative work-up could not reveal the definite cause of bleeding. During exploration, hemangioma scattered in whole small bowel was identified and feeding vessel ligation was performed. Postoperative recurrent bleedings were controlled by additional estrogen therapy. A 25-year-old young woman had suffered from painless anal bleeding with subsequent anemia since her youth. She had diffuse carvernous hemangioma in the large intestine involving the anal canal and uterus. Total proctocolectomy and ileal-pouch anal anastomosis was performed, however the uterine hemangioma was left intact because the patient wanted to be pregnant. She was also treated with estrogen, postoperatively. It is suggested that estrogen may be a good alternative treatment modality for gastrointestinal hemangioma that can not be removed completely.
Adolescent ; Adult ; Anal Canal ; Anemia ; Estrogens ; Female ; Gastrointestinal Tract ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Intestine, Large ; Ligation ; Male ; Melena ; Middle Aged ; Uterus ; Viscera

Cleft lip and palate are common defects in congenital deformity. Nose deformity is most common among various facial deformities at the center of face. So we must operate to correct the deformity at the earliest stage to give the patients and parents mental relief from anxiety. It is also necessary to establish the facial anthropometry in newborns, because of the current trend of early intervention, such as fetal surgery, lip adhesion, and use of nasoalveolar molding devices. But there is a lack of literature and research on newborns. So we carried out this research to form base data for operations. The nose of 90 newborns in Gwangju-Jeonnam area were analyzed quantitatively, based on 13 facial measuring points and 18 anthropometric values taken directly from the face of newborns. The relationship between the nasal measurements were studied in 11 proportion indices. Followings are our results for newborns. Width of the nasal root was 13.9mm. Width of the nose was 22.1mm. Width of the columella was 4.5mm. Height of the nose was 22.6 mm. Length of the nasal bridge was 20.1mm. Nasal tip protrusion was 8.9 mm. Width of the nostril floor was 6.4mm. Thickness of the nasal ala and length of the nasal ala were 4.0mm, 15.4mm. Length of the columella was 3.9mm. The most common nostril shape was Type II(0-45 degrees in inclination of the nostril axis from the horizontal). Nasal index was 97.8. Columella-nasal tip protrusion length index was 43.9. The development of the columella was relatively incomplete in the case of newborns. The normal indices could be used clinically in identifying it's normality as well as morphologic characteristics of the craniofacial structures. They also could be used in different diagnosis between the morphologically similar congenital craniofacial anomalies, in preoperative design, and assessing the effect of the operation.
Anthropometry* ; Anxiety ; Axis, Cervical Vertebra ; Cleft Lip ; Congenital Abnormalities ; Diagnosis ; Early Intervention (Education) ; Fungi ; Humans ; Infant, Newborn* ; Lip* ; Nose* ; Palate ; Parents

BACKGROUND: Food restriction has been reported to ameliorate diabetes and obesity. In this study, we examined the effects of the food restriction on phenotypes of TALLYHO/JngJ (TH) mouse, a recently developed diabetic model animal. METHODS: 3 week-old TH mice were divided into 2 groups (n = 20 each for food-restricted (THR) and free-fed (THF)) and THR mice were fed the same amount of food as normal control mice (C57BL/6, n = 20). Body weight was weekly monitored till 14 weeks of age. The half of animals were sacrificed at 8 weeks of age, and liver, kidney, and fat weight were measured. The histopathology of liver and brown fat tissues and mRNA expression of leptin in adipose tissue were analyzed. The oral glucose tolerance test and insulin resistance test was done at 14 weeks of age. The plasma concentrations of glucose, free fatty acid, triglyceride, cholesterol and leptin were analyzed. RESULTS: The THR mice had lower body weights than the THF mice, similar to C57BL/6 mice, with reduced fat deposition in liver and brown fat tissue. The plasma levels of glucose, triglyceride and free fatty acid were decreased in the THR group. The THR mice, however, carried more fat than normal mice, with increased plasma leptin concentration and leptin mRNA expression in fats and no alteration in plasma cholesterol levels. Furthermore, the THR mice revealed glucose intolerance with impaired after-meal insulin secretion and slight insulin resistance CONCLUSION: The food restriction apparently ameliorated the obesity and diabetic phenotypes of TH mice. However, plasma concentration of cholesterol were not improved in THR mice with increased adiposity index and glucose intolerance, suggesting the genetically prone tendency of obesity and diabetes development in TH mice possibly with an impairment in cholesterol metabolism.
Adipose Tissue ; Adipose Tissue, Brown ; Adiposity ; Animals ; Body Weight ; Cholesterol ; Diabetes Mellitus ; Fats ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Insulin ; Insulin Resistance ; Kidney ; Leptin ; Liver ; Mice ; Obesity ; Phenotype ; Plasma ; RNA, Messenger

PURPOSE: Angiogenesis, playing a critical role in tumor growth, development, and metastatic process, is alleged to be related to the prognostic factors and patient's survival of the colo-rectal cancer. The p53 gene, present in short arm of chromosome 17, is involved in multistep colo-rectal carcinogenesis. The correlation of p53 gene and angiogenesis has been recently reported. So, we designed to assess (1) the rate of p53 overexpression, (2) the prognostic significance of microvessel count, and (3) the relationship of p53 overexpression and angiogenesis in early colo-rectal cancer(ECC) patients. MATERIAL AND METHODS: The study material included 68 ECC from 65 patients, 40 mucosal (m-ECC) and 28 submucosal ECCs (sm-ECC). Immunostainings against p53 and factor VIII-related antigen were done and the results were analyzed with respect to tumor depth, site, and differentiation. And also the correlation between p53 overexpression and microvessel counts(MVC) was performed. RESULT: The rate of p53 overexpression was higher in sm-ECC than in m-ECC (p < 0.05). The rate of p53 overexpression was highest in sigmoid colon and statistically significantly different compared with other sites. The differentiation of the tumor was closely correlated with p53 overexpression and the poorer the differentiation, the more overexpression of p53 (p<0.05). There was no significant difference between MVCs of m-ECC and sm-ECC (27.2+/-5.5 and 29.8 +/-6.0,respectively). However, MVC were higher in sigmoid colon than in any other sites (p<0.05). MVC did not show significant correlation with tumor differentiation or p53 overexpression. CONCLUSION: These data indicate that p53 overexpression is correlated with tumor depth and differentiation but not MVC. The significance of higher MVC and p53 overexpression in sigmoid colon are reserved for further studies.
Arm ; Carcinogenesis ; Chromosomes, Human, Pair 17 ; Colon, Sigmoid ; Colorectal Neoplasms* ; Genes, p53 ; Humans ; Microvessels* ; von Willebrand Factor

Erlotinib is accepted as a standard second-line chemotherapeutic agent in patients with non-small cell lung cancer who are refractory or resistant to first-line platinum-based chemotherapy. There has been no previous report of bowel perforation with or without gastrointestinal metastases related to erlotinib in patients with non-small cell lung cancer. The exact mechanism of bowel perforation in patients who received erlotinib remains unclear. In this report, we report the first case of enterocutaneous fistula in a female patient with metastatic non-small cell lung cancer 9 months, following medication with erlotinib as second-line chemotherapy.
Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Carcinoma, Non-Small-Cell Lung/complications/*drug therapy ; Female ; Humans ; Intestinal Fistula/*chemically induced/complications/radiography/surgery ; Intestinal Perforation/*chemically induced/complications/radiography/surgery ; Protein Kinase Inhibitors/*adverse effects/therapeutic use ; Quinazolines/*adverse effects/therapeutic use ; Sigmoid Diseases/*chemically induced/complications/radiography/surgery

BACKGROUND AND OBJECTIVES: With the recent development of endoscopic nasal surgery, endoscopic sphenopalatine artery ligation allows for secure control of posterior epistaxis with considerably low recurrence and complications. Surgical approaches to the sphenopalatine foramen to ligate the sphenopalatine artery are transantral, intranasal, and transseptal. However, the procedures have considerable limitations. Therefore, we have revised the transturbinal approach, which was described by Togawa for intranasal vidian neurectomy in 1977, to ligate the sphenopalatine artery in two patients of intractable posterior epistaxis, and describe our technique of the trans-inferior turbinate approach for endoscopic sphenopalatine artery ligation. SURGICAL TECHNIQUE: A longitudinal incision is made along the lower border of the inferior turbinate, and the mucoperiosteal flaps are developed to the lateral nasal wall. The posterior two-thirds of the inferior turbinate bone is removed from the lateral nasal wall. The posterior lateral nasal artery on the upper flap is positively identified, and followed to the posterior end of the middle turbinate bone. The sphenopalatine foramen can be localized after removing the posterior end of the middle turbinate bone, and the sphenopalatine artery is ligated with hemoclips or divided with bipolar electrocautery. RESULTS: With the trans-inferior turbinate approach, it was possible to identify and ligate the sphenopalatine artery and its branches in the sphenopalatine foramen with no immediate or delayed complications. CONCLUSION: The trans-inferior turbinate approach provides unobscured surgical access to the posterior nasal cavity, and enough working space for endoscopic manipulation. The posterior lateral nasal artery is a reliable surgical landmark leading to the sphenopalatine foramen.
Arteries* ; Electrocoagulation ; Epistaxis ; Humans ; Ligation* ; Nasal Cavity ; Nasal Surgical Procedures ; Recurrence ; Turbinates*

BACKGROUND: This research is to find out the object of Medical Phone Counsel rational and satisfactory by investigating in local clinic the actual state of Medical Phone Counsel, which is a form of medical care between doctor and patient, and by grasping the difference of expectation and recognition between doctor and patient on Medical Phone Counsel which is one of the service items of Attending Physician Registration System which is to be put into effect in near future. METHODS: This research conducted a se7-administered questionnaire targeting all practitioners to the number of forty four who gave primary care in Kangnung city from August to September in 1999, and each twenty patients Per Practitioner. This research compared and analyzed the difference of recognition between doctor and patient on the following contents of Medical Phone Counsel ; General Characteristic, Frequency, Contents, Time, Satisfiability, For or Against the Medical Phone Counsel to be executed under Attending Physician Registration System and Expectations. RESULTS: The questionnaire for doctor had a 70.5% of response rate, and the one for patient 17.2%. The 40.7% of the practitioners took a Phone Counsel actively, the 55.6% took part in Phone Counsel passively and the rest 3.7% did not participate in it. The 74.2% of them took this counsel for less than three minutes. Regarding recognition on Phone Counsel, the 48.1% of them answered that they executed it as it is their duty and the 48.4% responded that they took it reluctantly in spite of their busy business. The 3.2% answered that it is not their duty. Among those in favor of Phone Counsel under Attending Physician (or Prime Doctor) Registration System, the 28.6% agreed as it is their own duty and the 71.4% was for it subject to economic compensation. While, the 62.9% of the patients answered that they had never experienced the Phone Counsel, and the 34.4% responded that they had experienced it one or two times in a yea. Among those who had experienced Phone Counsel, the 46.4% was satisfied with it. As far as the difference of expectation and recognition between doctor and patient on Medical Phone Counsel is concerned, only 45.2% of the practitioners were in favor of Medical Phone Counsel under the Attending Physician Registration System. While, the 70.1% among the patients was in favor of its execution. These two values showed a significant difference between doctor and patient (P<0.05), And the 83.9% of the practitioners insisted that the charge should be paid against Phone Counsel and only 56.2% of the patients insisted the same. There was also a significant difference between two values. (P<0.05) CONCLUSION: The practitioners were taking part in Medical Phone Counsel at any form. To the contrary, most of the patients were not. As far as the systematization of Phone Counsel is concerned, most of the practitioners had mental reluctance if there is no economic compensation. On the other hand, most of the patients had high expectation regardless of economic matters. If Medical Phone Counsel becomes systematized, it is expected that there will be a great trouble between its supply and demand.
Commerce ; Compensation and Redress ; Hand ; Hand Strength ; Humans ; Primary Health Care* ; Surveys and Questionnaires