Aggressive angiomyxoma is a rare soft tissue tumor associated with high risk of local recurrence but lacks metastatic potential. This tumor arise from soft tissue of the perineum or lower pelvis, and affect predominantly yonug women. Aggressive angiomyxoma should be distinguished from more common benign and malignant tumor or tumor like conditions of the pelvic soft part. We report a case of an ususual angiomyxoma in ischiorectal fossa with a brief review of the literature.
Female ; Humans ; Myxoma* ; Pelvis ; Perineum ; Recurrence

This study was primarily undertaken to assess the value of continuous spinal anesthesia for total hip replacements (Charnley's low friction arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. The results were as follows: 1. Preoperative diagnosis was in 4 cases hip joint tuberculosis,in 2 cases avascular necreosis, in 2 cases femur fracture, and in 2 cases osteoarthritis of the hip joint. 2. Average blood loss was 2, 800 ml for a one side operation and 5, 000 ml for a bilateral one. Overall average blood loss with continuous spinal anesthesia was 2, 600 ml and with general anesthesia was 1, 725 ml, and with amount of difference being 1. 175 ml more in the spinal anesthesia group (p<0. 025). 3. In 4 eases (40%) the hypotensive range was over 30% of the preoperative level, but recovery occurred soon after administration of Effortil. 4. Practically management of a patient with continuous spinal anesthesia is easier' thai with general anesthesia for total hip replacement, with fieeing of the anesthesio1ogist'a hands for better care of the patient during anesthesia.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal* ; Arthroplasty, Replacement, Hip* ; Asian Continental Ancestry Group ; Diagnosis ; Etilefrine ; Femur ; Friction ; Hand ; Hip Joint ; Humans ; Osteoarthritis ; Wounds and Injuries

PURPOSE: Recurrent colorectal cancers have important and difficult diagnostic and treatment problems. The purpose of this study is to evaluate the rationale and the efficacy of surgical re-treatment for patients with recurrence following curative surgery for colorectal cancer. METHODS: From January 1991 to December 2002, we experienced 60 (20.9%) patients with recurred colorectal cancer among 287 patients who had curative operations in our hospital. These 60 patients were divided into three groups. Patients in group 1 had curative-intent resections, patients in group 2 had palliative resections, and patients in group 3 had conservertive treatment. The groups consisted of 17 (28.3%), 10 (16.7%) and 33 (55.0%) patients, respectively. We analyzed retrospectively those groups for any recurrence pattern and for survival. RESULTS: Of the 60 patients with recurrent colorectal cancer, in 20 (33.3%) patients the cancer recurred in the colon, and in 40 (66.7%) it recurred in the rectum. Local recurrence was seen in 9 (15.0%) patients, liver metastasis in 25 (41.7%), and pulmonary metastasis in 13 (21.7%). The 1- and 3-, and 5-year survival rates were 86.5%, 31.7%, and 15.9%, respectively, for group 1, 33.3%, 0%, and 0% for group 2, and 28.9%, 4.4%, and 4.4% for group 3. The median survival period was 31 months for group 1, 8 months for group 2, and 7 months for group 3. CONCLUSIONS: Although evaluation was difficult owing to the small number of patients with recurrent colorectal cancer, a significant difference in survival rates was observed between the treatment groups. On the basis of these results, we think that curative-intent aggressive surgery for recurrent colorectal cancer in appropriately selected cases can clearly prolong survival when compared with palliative resections and conservative treatment.
Colon ; Colorectal Neoplasms* ; Humans ; Liver ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate

PURPOSE: RUNX3, a novel tumor suppressor, is frequently inactivated in gastric cancer. In the present study, we examined the pattern of RUNX3 expression in gastric cancer cells from gastric cancer specimens and the impact of its alteration on clinical outcome. MATERIALS AND METHODS: A total of 124 samples of both gastric cancer and normal tissue were obtained from 124 patients who underwent curative gastrectomy at the Seoul Medical Center from January 2001 to December 2005. RUNX3 expression was determined by immunohistochemical staining, and the results were analyzed. Statistical analysis wabased on clinicopathological findings and differences in survival rates. RESULTS: The mean age of the patients was 61 years, and the male:female ratio was 1.9:1. The expression rate of RUNX3 was 59.7% (74/124). The expression rate was higher in differentiated gastric cancers (nucleus: 9.1%, cytoplasm: 57.6%) than in the undifferentiated types (nucleus: 5.2%, cytoplasm: 46.6%) (P=0.133). The 5-year survival rates according to RUNX3 expression determined from cancer tissue were 88.9% for the nucleus +/- cytoplasm(+) group of patients, 76.1% for the cytoplasm only (+) group of patients, and 65.3% for the RUNX3 negative expression group of patients (P=0.626). Only UICC TNM staging showed statistical significance related to the survival rate, as determined by multivariate analysis. CONCLUSION: The RUNX3 expression rate was higher in differentiated gastric cancer than in the undifferentiated types without significance. Although RUNX3 expression predicted better survival, based on multivariate analysis, the finding was not statistically significant. More cases should be further evaluated.
Cytoplasm ; Gastrectomy ; Humans* ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Seoul ; Stomach Neoplasms* ; Survival Rate

PURPOSE: There have been many different kinds of operations for obstructing left colon (distal to splenic flexure) cancer and rectal cancer because immediate resection and anastomosis was known to cause many complications. We performed this study to analyse operative cases and evaluate which procedure had the better result. METHODS: Thirty-six cases of left colon cancer and rectal cancer with complete obstruction were analysed from April 1990 to January 2001 and those cases were divided into two groups, the group of staged procedure and the group of primary resection. 28 cases were curative operations and 8 cases were palliative operations. RESULTS: The group of staged procedures had 17 cases of curative operations with 1st. stage-colostomy and 2nd. stage-cancer resection. And the group of primary resection had 11 cases of curative operations, 6 cases of Hartmann's procedures, 2 cases with intraoperative colonic lavage and resection and 3 cases with cancer resection, anastomosis and proximal colostomy. There were no differences in the distribution of age and cancer stage between two groups. In both groups, the sigmoid colon was the most prevalent obstruction site. The staged procedure group had higher operative mortality (25%) than the primary resection group (8%). And 5-year survival rate of the primary resection group was higher than that of the staged procedure group (45%: 33%), but there was no statistical significance. CONCLUSIONS: We think that the primary resection is the better surgical procedure because of shorter hospital stay and fewer operations in the treatment of obstructing left colon and rectal cancer.
Colon* ; Colon, Sigmoid ; Colonic Neoplasms ; Colostomy ; Length of Stay ; Mortality ; Rectal Neoplasms ; Rectum* ; Survival Rate ; Therapeutic Irrigation

BACKGROUND: We performed a prospective, randomized, controlled trial to compare the quality, hemodynamic response, and recovery index of laryngeal mask airway (LMA) insertion after either propofol alone or co-administration of alfentanil-propofol anesthesia. METHODS: Sixty patients (ASA 1 or 2, 17-63 years) were randomly allocated to control and experimental group. Control group(Group I) was received placebo (saline), experimental groups were received alfentanil 10microgram/kg (Group II), 20microgram/kg (Group III), 30microgram/kg (Group IV). RESULTS: Loss of consciousness and LMA insertion were more rapid in patients with alfentanil 30 microgram/kg group than control group (P<0.05). In alfentanil 20microgram/kg group, loss of consciousness was more rapid than control group. Also, there were significant differences in propofol induction dose, effect site concentration on induction, and propofol maintenance dose between control and experimental group (P<0.05). CONCLUSIONS: We conclude that co-adminstration of alfentanil-propofol, especially 30microgram/kg group, compares favorably with propofol alone, although LMA removal time is prolonged.
Alfentanil ; Anesthesia ; Hemodynamics ; Humans ; Laryngeal Masks* ; Propofol* ; Prospective Studies ; Unconsciousness

Intracranial tuberculoma results from hematogenous spread of pulmonary, intestinal or urogenital tuberculosis. However, it might be caused by pulmonary tuberculosis, mainly. Clinically, symptoms of intracranial tuberculoma are headache and seizure, its symptoms are simillar to intracranial tumor. A 25-year-old-unmarried shopgirl was visited to this hospital because of headache, dizziness and visual disturbance for couple weeks in Sep. 1995. She had been treated with anti-tuberculosis agents of miliary tuberculosis during past nine months period. Brain MRI revealed intracranial tuberculoma and brain edema but not involved optic nerve. Ophthalmic examination revealed severe papilledema and splinter hemorrhage with bitemporal hemianopsis and central scotoma. This finding was strongly suggested of optic disc tuberculoma. Her symptoms became much better following repeated retrobulbar steroid injection with continuous anti-tuberculosis agents. We report a interesting case with intracranial tuberculoma and optic disc tuberculoma associated by miliary tuberculosis during anti-tuberculous treatment.
Brain ; Brain Edema ; Dizziness ; Headache ; Hemorrhage ; Magnetic Resonance Imaging ; Optic Nerve ; Papilledema ; Scotoma ; Seizures ; Tuberculoma* ; Tuberculoma, Intracranial* ; Tuberculosis, Miliary* ; Tuberculosis, Pulmonary ; Tuberculosis, Urogenital

PURPOSE: Recently, interest in peroxisome-proliferator-activated receptors (PPAR) has increased, although clinical studies of the effect of PPAR-gamma expression on gastric cancer have not been reported yet. In this study, we investigated the role of PPAR-gamma expression in gastric cancer patients. MATERIALS AND METHODS: One hundred twenty-eight (128) samples of both gastric cancer and normal tissues were obtained from 128 patients who had undergone at a curative gastrectomy at Seoul Medical Center from Jan. 2001 to Dec. 2005. PPAR-gamma expression was determined by using immunohistochemical staining, and the results were analyzed. The statistical analysis was based on clinicopathological findings and the differences in survival rates. RESULTS: The mean age of the patients was 61, and the male:female ratio was 1.9:1. PPAR-gamma expression was significantly higher in cancer tissues than in normal tissue (81.3% vs. 57.0%, P<0.001). There was insignificant difference between well and moderately differentiated types and poorly differentiated types in terms of the expression of PPAR-gamma (87.0% vs. 74.6%, P=0.074). In the univariate analysis the survival rate was significantly increased when PPAR-gamma was expressed in normal tissue (P=0.003). In the multivariate analysis, only the UICC TNM staging had significance related to the survival rate. CONCLUSION: The rate of PPAR-gamma expression was higher in cancer tissue than it was in normal tissue from gastric cancer patients. In the univariate analysis, PPAR-gamma expression in normal tissue had significance with respect to survival, but the multivariate analysis showed no such significance. Thus, we should further evaluate more cases to determine whether or not such a significance exists.
Gastrectomy ; Humans* ; Multivariate Analysis ; Neoplasm Staging ; Peroxisome Proliferator-Activated Receptors ; Seoul ; Stomach Neoplasms* ; Survival Rate

PURPOSE: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. MATERIALS AND METHODS: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. RESULTS: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage (> or =T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size (> or =5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage (> or =T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. CONCLUSION: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.
Carcinoma, Non-Small-Cell Lung ; Disease-Free Survival ; Humans ; Mastectomy, Segmental ; Multivariate Analysis ; Pneumonectomy ; Recurrence ; Retrospective Studies