No abstract available.
Lymphangioma, Cystic* ; Turner Syndrome* ; Ultrasonography*

PURPOSE: Although staged operations have been thought a main treatment for obstructive left colon cancer, their disadvantages make one-stage operations popular. We tried to identify technical feasibility and oncologic safety of one-stage operation with intra-operative lavage (IOL) for the treatment of obstructive left colon and rectal cancer. METHODS: From June 1996 to May 1999, of 456 colorectal cancer patients, 25 with obstructive left colon or rectal cancer underwent surgery. In 18 of those, we intended to do a one-stage operation with IOL. Male (n=14) were predominant to female (n=4). Mean age was 61.2 (29~78) years. Lesions were located on the sigmoid colon in 8, rectum in 4, descending in 3, and rectosigmoid junction in 3 cases. Operative technique: Lymphovascular division was initiated at the origin of IMA followed by mobilization of the left colon up to the splenic flexure and distal transverse colon. Thereafter antegrade irrigation of the proximal colon with warm normal saline was done by using a corrugated tube. Anastomoses were made by hand or stapler in end-to-end or side-to-end fashion. RESULTS: Mean operative time was 221 (185~360) min. No significant post-operative complications occurred except for two wound infections and one pulmonary atelectasis. There was one unexpected conversion to Hartmann's procedure due to intra-operative fecal soilage during the lavage. Within 18 months follow-up period, 4 recurrences occurred with two of them expiring. CONCLUSIONS:: One-stage operation for the treatment of obstructive left colon cancer with IOL could avoid colostomy or reoperation, and, was technically feasible, safe, and oncologically acceptable.
Colon* ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms* ; Colorectal Neoplasms ; Colostomy ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Operative Time ; Pulmonary Atelectasis ; Rectal Neoplasms ; Rectum ; Recurrence ; Reoperation ; Therapeutic Irrigation* ; Wound Infection

Once splinter hemorrhage can be considered as a pathognomonic sign of subacute bacterial endocarditis. But it can also be associated with a variety of systemic disorders that increase capillary fragility or primary nail bed involvement in dermatologic disorders. The cause of splinter hemorrhage can usually be established by careful history and physical examination. We report a case of 33-year-old man with splinter hemorrhages, who had polycythemia vera.
Adult ; Capillary Fragility ; Endocarditis, Subacute Bacterial ; Hemorrhage* ; Humans ; Physical Examination ; Polycythemia Vera* ; Polycythemia*

No abstract available.
Dislocations* ; Tendons*

Identifying remains is an important role of forensic medicine. For identification, dating, i.e., estimating the birth year and death year, is expected as useful, however has not yet been practically applied. A dating method using radiocarbon analysis was recently introduced and related studies have been reported. In this study, we conducted radiocarbon analysis on teeth and aimed to develop a formula to estimate the birth year. Fifteen autopsy cases from the National Forensic Service, from December 2014 to December 2020, with known birth year were selected for inclusion. For each case, dentin of the first molar in mandible was taken, radiocarbon analysis was carried out and the corresponding estimated birth year were calculated using the bomb peak curve. The differences between the birth year and the teeth year were determined and analyzed on the influence of variables. A formula for estimating the birth year was developed and the applicability of the formula was determined. The difference between the birth year and the teeth year was 2.6 years on average for cases born before 1963, and 5.7 years for those born after 1963. The estimation formula of birth year was as follows: (Before 1963) Birth year=0.565×(Tooth year)–0.446×(Age)+875.001, (After 1963) Birth year=Tooth year–5.7. This study is meaningful in that it reduced the error by using only the first molars of the lower jaw as a sample, and presented an estimation formula of birth year that can be applied in practice through radiocarbon analysis of teeth.

The identification for skeletal remains is one of roles of forensic medicine. For this purpose, dating, i.e., estimating the birth year and death year is expected as useful, however has not yet been practically applied. A dating method using radiocarbon analysis was recently introduced and related studies have been reported. In this study, we tried to confirm the applicability of radiocarbon dating for the identification of skeletal remains and to develop formulas to estimate the death year. Thirty-four autopsy cases from the National Forensic Service, from December 2014 to July 2022, with known death year were selected for inclusion. For each case, two samples were taken: the spongy bone of the femur head, and the compact bone of the femur midshaft. For each sample, radiocarbon analysis was carried out and the corresponding femur year were calculated using the bomb peak curve. The differences between the femur year and the death year were determined and analyzed on the influence of variables. A formula for estimating the death year was developed and the applicability of the formula was determined. The results showed that the difference between death year and femur head year was 14.2 years on average. In male, the difference between death year and femur head year increased with age, however, it did not show any difference according to age in female. The estimation formula of death year was as follows: (In male) Death year=0.993×(Femur head year)+0.288×(Age)+15.061, (In female) Death year=0.769×(Femur head year)-0.218×(Age)+489.676. The formula for male had relatively high explanatory power (adjusted R2=0.710), however, the formula for female had low explanatory power (adjusted R2=0.588). This study is meaningful because it is the largest single study of its kind, to date, and uses specific and identical skeleton (femur head/femur midshaft) to increase the accuracy of the death year estimation. We expect that the results of this study will be supplemented through additional research in the future.

Using 3D ultrasound, bilateral chylothorax was diagnosed antenatally in the second trimester. Apparently stable, bilateral pleural effusion progressed rapidly to severe hydrops with facial edema during observation, and then we decided bilateral pleural-amniotic shunt operation. Here we present a case where drainage of pleural effusion by a double reverse pig tail stent made by ourself was achieved, although placement of the thoracoamniotic shunt resulted in near complete drainage of bilateral pleural effusion with normalization of intrathoracic anatomic relationships, subsequent resolution of fetal hydrops, but the ultimate outcome was unsuccessful due to the internalization of one catheter and unknown sudden death. We think that ongoing research is required to further evaluation about complications associated with this procedure, specifically failure of function due to obstruction, migration of the catheter,
Catheters ; Chylothorax* ; Death, Sudden ; Drainage ; Edema ; Female ; Humans ; Hydrops Fetalis ; Pleural Effusion ; Pregnancy ; Pregnancy Trimester, Second ; Stents ; Tail ; Ultrasonography

BACKGROUND/AIMS: Phase IIb clinical study of Stillen(TM), a novel cytoprotectant, for gastritis showed 180 mg of Stillen, t.i.d. for 2 weeks results in a significant increase of cure rate when compared with a placebo group. It is reported that antioxidative effect and strengthening the endogenous cytoprotective molecules of the gastric mucosa play a pivotal role for cytoprotective action of Stillen(TM). The aim of this phase III multicenter, double-blind comparative study was to assess the efficacy of Stillen(TM) for the treatment of erosive gastritis. METHODS: Five hundred and twelve patients with erosive gastritis were enrolled and divided into three groups. Each group received 180 mg or 360 mg of Stillen(TM) or 600 mg of cetraxate (Neuer(TM)) t.i.d. for 2 weeks, respectively and a follow-up endoscopic examination for evaluation. RESULTS: Patients treated with 180 mg and 360 mg of Stillen(TM) had a significantly improved endoscopic cure rate of gastritis (55.6% and 57.5%, respectively) compared with patients treated with 600 mg of cetraxate (35.5%, p<0.001). Endoscopic improvement rate was also significantly higher in 180 mg group (67.3%) and 360 mg group (65.0%) of Stillen(TM) treated patients than cetraxate treated group (46.4%, p<0.001). During the study, both Stillen(TM) and cetraxate were well tolerated. CONCLUSIONS: These results clearly demonstrate that Stillen(TM) is an efficacious, safe, and well-tolerated treatment for gastritis.
Follow-Up Studies ; Gastric Mucosa ; Gastritis* ; Humans

Since the introduction of extracorporeal shock wave lithotripsy(ESWL), percutaneous nephrolithotomy(PNL) has been performed in limited cases of the patients requiring a stone procedure. The roles of PNL in the era of ESWL were reviewed through analysis of 86 patients treated with PNL. From July 1987 to December 1994, 86 patients(89 renal units) underwent percutaneous extraction of renal or upper ureteral stone. From July 1987 to January 1990, PNL was performed as the first choice for the treatment of 69 cases out of 119 renal or upper ureteral stone, and PNL was done in 58.0% (69/119) of the cases. From February 1990 to December 1994 when ESWL was available at our hospital, PNL was done in 20 cases of ESWL resistant stone or large volume stone, and PNL was done in 1.5%(20/1,362) of renal or upper ureteral stone. In the era of ESWL in our hospital, ESWL were performed in 94.5% of renal or upper ureteral stone, open surgery in 3.0%, PNL in 1.5% and conservative treatment in 1.0%. Initial success rate of PNL was 86.9%(60/69 cases) and subsequently when ESWL was available at our hospital, it became 95.0%(19/20 cases), probably due to accumulated experiences. Subsequently decreased complications of PNL such as persistent urinary leakage, prolonged hematuria, ureteral perforation and paralytic ileus. Though the introduction of ESWL in our hospital also brought about dramatic ally decreased use of PNL, PNL continues to have a primary role in the management of renal or upper ureteral stone in limited cases such as patients refusing ESWL, ESWL resistant stone or large volume stone.
Hematuria ; Humans ; Intestinal Pseudo-Obstruction ; Lithotripsy* ; Nephrostomy, Percutaneous* ; Shock* ; Ureter

No abstract available.
Humans ; Male ; Spinal Cord Injuries* ; Spinal Cord*