Disinfection ; Escherichia coli ; isolation & purification ; Hospitals ; Medical Waste ; Sewage ; Waste Products ; Water Microbiology

BACKGROUND/AIMS: Primary appendiceal adenocarcinoma is a rare neoplasm that constitutes less than 0.5% of all gastrointestinal neoplasm. The aim of this study was to figure out its clinicopathologic characteristics that are not well understood. METHODS: We reviewed the medical records of nineteen patients (9 males and 10 females) with histologically proven appendiceal adenocarcinoma. They had been treated at Asan Medical Center between June 1989 and December 2002. Their median follow-up duration was 72.5 months. RESULTS: Their median age was 56.5 (range, 33~80) years. Thirteen patients had mucinous variants and the other five had adenocarcinoma. Seven patients (36.8%) were diagnosed as acute appendicitis. In fact, none of the patients was diagnosed correctly before surgery. The operative procedure, included right hemicolectomy in 9 patients, appendectomy alone in 2 patients, and debulking of their tumors or a biopsy in 8 patients. The 5-year survival rate was 20.5%. The patients with mucinous type had better prognosis than those with the non-mucinous type (p<0.01). In the patients with mucinous type, the survival rate after debulking operation was similar to that after right hemicolectomy. CONCLUSIONS: The most important prognostic factor of primary appendiceal adenocarcinoma was histology. The outcome of debulking operation is being watched compared with that of right hemicolectomy in mucinous variant.
Adenocarcinoma/*diagnosis/mortality/surgery ; Adult ; Aged ; Appendiceal Neoplasms/*diagnosis/mortality/surgery ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Survival Rate

Carcinoma ; diagnostic imaging ; secondary ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; Pancreatic Neoplasms ; diagnostic imaging ; secondary ; Ultrasonography

BACKGROUND/AIMS: We aimed to verify the prognostic factors of stage II rectal cancer and the effect of radiation therapy on the survival and local recurrence rate. METHODS: This study was undertaken in 202 patients who underwent curative resection of rectal cancer and confirmed to be stage II between July 1989 and December 1996. Univariate and multivariate (Cox's model) analyses of survival were employed to identify prognostic factors. Statistical significance was assigned by p value of <0.05. RESULTS: Overall recurrence occurred in 32 patients. Four patterns of recurrence were observed: hematogenous recurrence in 17 patients, local recurrence in 11, peritoneal seeding in two and simultaneous hematogenous and local recurrence in two cases. Overall 5-year survival rate was 85.6% and 5 year disease free survival rate was 82.8%. There was no significant difference in local recurrence rate and survival according to radiation therapy or location of cancer. In multivariate analysis, the number of harvested lymph node was only a prognostic factor. CONCLUSIONS: The number of harvested lymph nodes has prognostic value in stage II rectal cancer. Postoperative radiation therapy should be considered for stage II rectal cancer with poor prognostic factors although radiation did not decrease local recurrence rate in present study.
Adolescent ; Adult ; Aged ; Child ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Rectal Neoplasms/pathology/*surgery

The treatment of patients with spontaneous intracerebral hemorrhage remains a matter of debate in neurosurgery and neurology. We analyzed 203 patients with spontaneous intracerebral hematoma and compared the result of treatment between two groups:100 patients with stereotactic hematoma evacuation and 103 patients with conservative treatment. Evaluation of outcome was performed at discharge with Glasgow coma scale, motor deficit, Glasgow outcome scle. Stereotactic surgical patients with medium sized(20-50 cc) hematoma, which located in basal gaglia and thalamic area made a significantly better functional recovery than did patients with conservative treated group. Patients with relatively mild neurologic deficit preoperatively had better functional outcomes in the stereotactic surgical group. Stuporous or comatose patients had no better outcome after surgery, but showed a significantly lower mortality rate than conservative treated group. There was no significant difference in the outcome in relation to the timing of surgery, but rebleeding risk was high on early operated patients. Stereotactic surgery can minimized the brain damage and be performed under local anesthesia, so there was a trend toward better quality of survival and chance of survival in the operated group.
Anesthesia, Local ; Brain ; Cerebral Hemorrhage* ; Coma ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Hematoma ; Humans ; Mortality ; Neurologic Manifestations ; Neurology ; Neurosurgery ; Stupor

In-stent stenosis is a feared complication of flow diversion treatment for cerebral aneurysms. We present 2 cases of patients treated with pipeline flow diversion for unruptured cerebral aneurysms. Initial perioperative dual antiplatelet therapy (DAPT) consisted of standard aspirin plus clopidogrel. At 6-month follow-up cerebral angiography, the patients were noted to have developed significant in-stent stenosis (63% and 53%). The patients were treated with cilostazol and clopidogrel for at least 6 months. Subsequent angiography at 1-year post-treatment showed significant improvement of the in-stent stenosis from 63% to 34% and 53% to 21%. The role of cilostazol as treatment of intracranial in-stent stenosis has not been previously described. Cilostazol’s vasodilatory effect and suppression of vascular smooth muscle proliferation provides ideal benefits in this setting. Cilostazol plus clopidogrel may be a safe and effective alternative to standard DAPT for treatment of in-stent stenosis following flow diversion and warrants further consideration and investigation.