PURPOSE: The aim of this study was to evaluate the impact of extended resection of primary tumor on survival outcome in unresectable colorectal cancer (UCRC). METHODS: A retrospective analysis was conducted for 190 patients undergoing palliative surgery for UCRC between 1998 and 2007 at a single institution. Variables including demographics, histopathological characteristics of tumors, surgical procedures, and course of the disease were examined. RESULTS: Kaplan-Meier survival curve indicated a significant increase in survival times in patients undergoing extended resection of the primary tumor (P < 0.001). Multivariate analysis showed that extra-abdominal metastasis (P = 0.03), minimal resection of the primary tumor (P = 0.034), and the absence of multimodality adjuvant therapy (P < 0.001) were significantly associated poor survival outcome. The histological characteristics were significantly associated with survival times. Patients with well to moderate differentiation tumors that were extensively resected had significantly increased survival time (P < 0.001), while those with poor differentiation tumors that were extensively resected did not have increase survival time (P = 0.786). CONCLUSION: Extended resection of primary tumors significantly improved overall survival compared to minimal resection, especially in well to moderately differentiated tumors (survival time: extended resection, 27.8 ± 2.80 months; minimal resection, 16.5 ± 2.19 months; P = 0.002).
Colorectal Neoplasms* ; Colorectal Surgery ; Demography ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Palliative Care ; Retrospective Studies

BACKGROUND: Chronic low back pain(CLBP) is one of the most common afflictions of humans. Between 70% and 80% of the population experience back pain some time during their lives. Especially, back pain is the most common cause of limited activity in individual under age 45. METHODS: The prepared questionnaire and SCL-MPD(symptom check list-minor psychiatric disorders) were presented to subjects who visited our hospital for occupational routine check. The questionnaire was composed of duration and severity of back pain. The subject were divided into two groups, respectively with chronic low back pain history and without history. The differences of psychogenic symptoms between both groups were analysed. RESULTS: In general characteristics, there was no significant difference between both groups. There were significant differences in somatization, anxiety, depression, anger-hostilily, phobic anxiety, neurasthenic, hypochondriacal, interpersonal sensitivity and general dimensions between both groups(P<0.05). There was no significant difference in obsessive-compulsive dimension between both groups. CONCLUSIONS: These results showed the presence of various psychogenic symptoms in chronic low back pain patients. Such psychosocial variables will need to receive additional careful attention in primary care setting.
Anxiety ; Back Pain ; Depression ; Humans ; Low Back Pain* ; Primary Health Care ; Surveys and Questionnaires

Bacillus species are aerobic, gram-positive, spore forming rods that are widely distributed in soil, dust, stream, and other environmental sources and are regarded as natural organism. But certain species of the genus Bacillus, most notably B.cereus, which is associated with food-borne illness, occasionally have been implicated in the occurrence of fatal illness and complication in a compromised host. We roport a case of pneumonia and bacteremia caused by B.cereus in an 81 year-old man, who had no obvious immunologic compromise. The condition was treated with combination of roxithromycin and gentamicin.
Bacillus cereus* ; Bacillus* ; Bacteremia ; Dust ; Gentamicins ; Pneumonia* ; Rivers ; Roxithromycin ; Soil ; Spores

Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/ surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.
Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Craniotomy ; Humans ; Male ; Middle Aged ; Molar ; Pathology ; Viridans Streptococci

Brain abscess is a rare, extremely aggressive, life-threatening infection. It may occur following : infection of contiguous structure, hematogenous spread, or cranial trauma/ surgery. Dental pathology and/or treatment have been linked to a small number of brain abscesses as possible source of infection. 50-year-old male patient was presented with a brain abscess caused by Streptococcus viridans. In the case presented, the significant oral findings were chronic periapical and periodontal infection due to root remnant of lower right 3rd molar. A case history and brief literature review of brain abscess related odontogenic infection was presented after successful treatment with antibiotics and craniotomy.
Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Craniotomy ; Humans ; Male ; Middle Aged ; Molar ; Pathology ; Viridans Streptococci

PURPOSE: To report clinical characteristics of thyroid-associated ophthalmopathy (TAO) in patients who previously underwent total thyroidectomy for thyroid cancer or a benign mass of the thyroid. MATERIALS AND METHODS: Of the patients who were diagnosed with TAO from March 2008 to March 2012, we performed a retrospective chart review on those who had undergone total thyroidectomy for thyroid cancer or a benign mass of the thyroid before the occurrence of ophthalmopathy. RESULTS: Of the 206 patients diagnosed with TAO, seven (3.4%) met the inclusion criteria. The mean age of the subjects was 47.4 years, and all were female. Six patients were diagnosed with papillary thyroid cancer, and one was diagnosed with a benign mass. The duration between total thyroidectomy and onset of TAO ranged from 3-120 months (median 48 months). Ophthalmic manifestations varied among cases. Except for the patient who was diagnosed with a benign mass, all patients showed hyperthyroid status and were under Synthroid hormone treatment at the time of TAO development. Five of these six patients had positive levels of thyroid-stimulating hormone (TSH) receptor autoantibodies. CONCLUSION: TAO rarely develops after total thyroidectomy, and the mechanism of TAO occurrence is unclear. However, most patients showed abnormalities in thyroid function and TSH receptor autoantibodies.
Adult ; Aged ; Autoantibodies/blood ; Carcinoma ; Carcinoma, Papillary/immunology/surgery ; Female ; Graves Ophthalmopathy/*diagnosis/immunology ; Humans ; Male ; Middle Aged ; Postoperative Complications/etiology/immunology/pathology ; Receptors, Thyrotropin ; Retrospective Studies ; Thyroid Neoplasms/complications/*surgery ; Thyroidectomy/adverse effects/*methods ; Thyrotropin/blood ; Treatment Outcome

PURPOSE: Epidemiologic studies have indicated that the use of nonsteroidal anti-inflammatory drugs, which inhibit cyclooxygenase activity, reduce the risk of colorectal cancer. In addition, several studies have demonstrated the increased expression of cyclooxygenase-2 (COX-2) in human colorectal cancer tissues. However, the role of COX-2 in colorectal cancer has not been fully established. The aim of this study was to clarify the clinicopathologic significance of COX-2 expression in human colorectal cancer. METHODS: We performed immunohistochemical straining for COX-2 expression in 124 human colorectal cancer specimens. COX-2 expression was then compared with clinicopathologic factors and survival outcomes. RESULTS: COX-2 was expressed in the cytoplasm of the cancer cells. COX-2 expression was noted in 86.3% of the cancer patients and significantly correlated with the histologic type. The depth of invasion, tumor size, lymph node metastasis and stage were not correlated with COX-2 expression. Multivariate analysis for the factors associated with survival showed that serum CEA, size, depth and lymph node involvement correlated with survival, but COX-2 expression had no correlation. CONCLUSION: These data suggest that COX-2 expression in primary lesion of colorectal cancer may not be a useful marker for evaluating prognosis. However, further studies are necessary for identification of the roles in colorectal carcinogenesis.
Carcinogenesis ; Colorectal Neoplasms* ; Cyclooxygenase 2* ; Cytoplasm ; Epidemiologic Studies ; Humans ; Immunohistochemistry ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Prostaglandin-Endoperoxide Synthases*

Lymphocytic hypophysitis, an inflammatory disease of the pituitary gland that is often associated with pregnancy, is caused by autoimmune destruction of the pituitary gland evidenced by diffuse inflammatory cell infiltration of the pituitary gland and some kinds of detectable autoantibodies. We report a case of lymphocytic hypophysitis in a 31-year-old woman presenting with severe hypoglycemia and hyponatremia after delivery. Hormonal study revealed panhypopituitarism and magnetic resonance imaging with enhancement showed the bulging contour of the right side pituitary gland with an ill-defined mass-like lesion and nodular thickening of the stalk. The patient's symptoms and biochemical data improved greatly with replacement of L-thyroxine and glucocorticoid. Partial recovery of panhypopituitarism was also seen. The follow-up tests revealed dramatic resolution of the pituitary lesion.
Adult ; Autoantibodies ; Female ; Follow-Up Studies ; Humans ; Hypoglycemia* ; Hyponatremia ; Hypopituitarism ; Magnetic Resonance Imaging ; Pituitary Gland ; Pregnancy ; Thyroxine

BACKGROUND: Prevalence of bee venom allergy in Korea is unknown, OBJECTIVE: We performed a cross-sectional study to evaluate the prevalence of bee venom allergy and importance of risk factors, such as age, sex, and atopy, in the development of the allergic reaction in children and adults living in rural area of Cheju Island. Swbject and METHOD: The prevalence was investigated in subjects with 1,054 children and 370 adults (701 male, 723 female), aged 7-87 years, living in rural area of Cheju Island. A history particularly focused on the systemic reactions after the bee stings was taken in all subjects. Skin prick test,s to common inhalant allergens, including house dust mites, fungi, tree, grass, mugwort and ragweed pollen, cockroach, animal epithelium, Japanese cedar pollen, and citrus red mite were performed. RESULT: The prevalence of bee venom allergy was 5.8% (mild systemic reactions 5.0%, severe systemic reactions 0.8% ). The prevalence was higher in adults than in children (10.2% vs. 5.0%, g = 12.0, p<0.01). Among the children, the prevalerlce wB.S Signifcantly higher ill male than in female (8.6% vs. 1.3%, x=28.7, p<0.01), but no significant diffecence was noted between male and female in adults (10.0% vs. 10.3%, p>0.05). The prevalence of bee venom allergy was not significantly different between subjects with positive skin reaction and those with negative skin reaction to inhalant allergens (6.4% vs. 5.4% ), Conclasion'. The prevlence of bee venom allergy in inhabitants of rural area of Cheju Island is 5.8% (mild systemic,' 5.0%, severe systemic reaction. 0.8%), and bee venom allergy was more common in adults than in children, and in male children than in female children.
Adult* ; Allergens ; Ambrosia ; Animals ; Artemisia ; Bee Venoms* ; Bees* ; Bites and Stings ; Child* ; Citrus ; Cockroaches ; Cross-Sectional Studies ; Cryptomeria ; Epithelium ; Female ; Fungi ; Humans ; Hypersensitivity* ; Jeju-do* ; Korea ; Male ; Mites ; Poaceae ; Pollen ; Prevalence* ; Pyroglyphidae ; Risk Factors ; Skin

We reported two cases of diabetic hyperglycemic hyperosmolar coma treated with maintaining continuous ambulatory peritoneal dialysis(CAPD) in chronic renal failure(CRF) patients with CAPD. Hyperglycemia is common complication in CAPD, but there were only few reports of severe hyperglycemia accompanying with hyperosmolar coma in CRF patients on CAPD therapy. Furthermore, to date, no specific management for CAPD patients with nonketotic hyperosmolar coma has been established. The best strategy for management of hyperosmolar coma with CAPD patients is changing CAPD therapy to HD. Recently, we experienced two cases of hyperglycemic hyperosmolar coma in diabetic CAPD patients successfully treated with intravenous hydration and insulin therapy without discontinuing CAPD therapy. Because no such case has been reported, we report two cases of diabetic hyperosmolar coma with CAPD treated without conversion to HD. These cases suggest that adequate fluid replacement accompanying electrolytes and osmotic balance as well as insulin therapy might be a major role for safe treatment of hyperglycemic hyperosmolar coma in patient with CAPD.
Coma* ; Electrolytes ; Humans ; Hyperglycemia ; Insulin ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory* ; Renal Dialysis