PURPOSE: The aim of this study was to review the outcome of local control after the local excision for T1/T2 rectal cancers and, thus, to assess its effectiveness as an alternative to a more radical resection. METHODS: This retrospective study analyzed 23 patients with T1/T2 rectal cancer treated by local excision (LE), and their results were compared with the results for 22 patients with rectal cancer of the same stage treated by a radical resection (RR). All patients with pT2 lesions in the LE group received postoperative adjuvant chemoradiation. The outcomes were defined as 5-year local-recurrence-free survival (LRFS). The median follow-up was 72 (range, 40~92) months. RESULTS: Recurrence occurred in 4 patients (pT1, 1; pT2, 3) in the LE group and in 3 patients (all pT2) in the the RR group. One patient with vascular invasion (T2N1M0) in the RR group showed multiple liver metastases at 23 months postoperatively. The difference in 5-year LRFS was not statistically significant between the two groups. In the LE group, the 5-year LRFS for pT2 lesions was significantly less favorable than that for pT1 lesions (40% vs. 94%; P= 0.005). The 5-year LRFS for pT2 in the RR group was more favorable than that in the LE group, although the difference was not statistically significant (76.9% vs. 40%, P=0.138). CONSLUSIONS: Local excision provides a favorable local control for pT1 rectal cancers. A more radical resection, however, remains an effective surgical option for pT2 lesions because local excision, even combined with adjuvant chemoradiation, showed substantial local recurrences.
Follow-Up Studies ; Humans ; Liver ; Neoplasm Metastasis ; Rectal Neoplasms* ; Recurrence ; Retrospective Studies

No abstract available.
Vascular Endothelial Growth Factor A*

No abstract available.
Hysterectomy* ; Sexual Behavior*

Familial adenomatous polyposis (FAP) is an autosomal dominant disease characterized by formation of multiple colorectal adenomas with nearly 100 percent potential for malignant transformation. FAP is a rare condition with an incidence of 1 in 10,000 live births. Germline mutations in the adenomatous polyposis coli gene (APC) located on chromosome 5q21 have been founded in many patients with FAP. Patients with FAP can have extracolonic manifestations of their disease. These include tumors of the upper gastrointestinal tract (hamartomatous polyps, adenomas, carcinomas), small intestine adenomas or cacinoma, bile duct adenomas, papillary thyroid carcinoma, osteomas of the mandible, skull, and long bones, a variety of soft tissue lesions, including fibromas, lipomas, and desmoid tumors, congenital hypertrophy of the retinal pigment epithelium (CHRPE) and hepatoblastoma. Hepatocellular carcinoma combined with FAP is a very rare condition. Just 8 cases of Hepatocellular carcinoma with a history of FAP have been reported in the literature. We now present a report of a case of Hepatocellular carcinoma with FAP (Gardner's syndrome) in a 19 year-old girl.
Adenoma ; Adenoma, Bile Duct ; Adenomatous Polyposis Coli* ; Carcinoma, Hepatocellular* ; Female ; Fibroma ; Fibromatosis, Aggressive ; Germ-Line Mutation ; Hepatoblastoma ; Humans ; Hypertrophy ; Incidence ; Intestine, Small ; Lipoma ; Live Birth ; Mandible ; Osteoma ; Polyps ; Retinal Pigment Epithelium ; Skull ; Thyroid Neoplasms ; Upper Gastrointestinal Tract ; Young Adult

PURPOSE: In the management of Hirschsprung's disease (HD), conventional Duhamel's, Swenson's or Soave's procedures have generally been performed. The author tried a new procedure, a transanal one-stage pull-through procedure (TOP). The aim of this study is to compare functional outcome of TOP with the conventional procedures that are generally used in treating HD. METHODS: Thirty-one cases received TOP procedure from November 2000 to December 2003. The postoperative results were evaluated by performing a retrospective medical record review, and by using as questionnaire. These results were then compared with reports' on patients after using one of the conventional procedures. RESULTS: In this study, the mean age of patients was 73.4 days, the mean hospital stay was 5.7 days and the mean follow-up period was 20.1 months. Postoperative results were as follows: (1) 23 cases (74.2%) had 1~2 times of defecation per day. (2) 26 cases (83.9%) had no problematic soiling. (3) 22 cases (70.9%) had soft consistency of stool. (4) 24 cases (77.4%) had no straining during defecation. (5) 25 cases (80.7%) didn't need stool softner. (6) In 14 cases (45.2%), an anal dilator was necessary for transient postoperative anal stricture. (7) After 24 months of age, a diaper was not necessary in 12 cases (70.6%). (8) The parents felt satisfactory in 28 cases (90.3%) for their children, as compared with the children from other families, and the parents felt satisfactory in 18 cases (94.7%) for the HD children compared with the other children of their family.(9) 23 cases (74.2%) had not shown constipation findings on simple abdomen film. (10) At the first digital rectal examination, perianal rash was found in 13 cases (41.9%), anastomotic stricture had occurred in 12 cases (38.7%), and normal squeezing pressure was felt in 27 cases (87.1%). However, at the last examination during the follow-up period, perianal rash was found in 2 cases (6.5%), the anastomotic stricture had not persisted, and normal squeezing pressure was felt in all cases (100%). (11) On the barium study, 13 months after operation, no retention of contrast within 24 hours was shown in 21 cases (95.5%). (12) According to the SanFilippo system, there were 24 excellent cases (77.4%) and 7 good cases (22.6%), so all the cases showed a favorable functional outcome. (13) In comparison with other reports' results, there was no significant difference between the author's outcomes and other reports' outcomes (p=0.752). CONCLUSION: This transanal one-stage pull-through procedure (TOP) seems to be as effective as the traditional method for the management of HD.
Abdomen ; Barium ; Child ; Constipation ; Constriction, Pathologic ; Defecation ; Digital Rectal Examination ; Exanthema ; Follow-Up Studies ; Hirschsprung Disease* ; Humans ; Length of Stay ; Medical Records ; Parents ; Surveys and Questionnaires ; Retrospective Studies ; Soil

PURPOSE: Necrotizing enterocolitis (NEC) is one of the most common surgical emergencies during the neonatal period. The aim of this study was to identify and assess the factors affecting the postoperative mortality in infants with NEC that require surgical treatment. METHODS: The authors retrospectively reviewed 37 infants surgically treated, at the Department of Surgery, Pusan National University Hospital, between Jan. 2000 and Dec. 2004. The patients were divided two groups according to the clinical outcomes; the survival and non-survival groups. Eight variables, i.e., sex, gestational age, weight at birth and at the time of the first operation, weight change between birth and the time of the first operation, degree of clinical manifestations (as a modified Bell's stage), interval between the onset of symptoms and the time of the first operation, the extent of necrotic intestine and associated anomalies, were analyzed. RESULTS: Among 37 infants, 6 expired (a mortality rate of 16.2%). The postoperative mortality was not affected by sex, gestational age, and the weight at birth and at the time of the first operation, weight change between birth and at the time of the first operation, degree of clinical manifestations and the interval between the onset of symptoms and the time of the first operation. However, the extent of necrotic intestine was associated with a significantly increased mortality (P=0.046). CONCLUSION: These data suggest that the extent of necrotic intestine is the only statistically significant factor affecting the postoperative mortality in infants with NEC that require surgical treatment.
Busan ; Emergencies ; Enterocolitis, Necrotizing* ; Gestational Age ; Humans ; Infant ; Intestines ; Mortality* ; Parturition ; Retrospective Studies

No abstract available.
Endometrial Neoplasms* ; Female

PURPOSE: We evaluated the MR and CT findings of the masticator space lesions in order to identify the differences among the malignant and benign tumors and infectious conditions. MATERIALS AND METHODS: MR and CT findings in 46 cases with proven masticator space lesions were reviewed retrospectively. We analysed the involvement of masticator muscles, adjacent spaces, orbit and intracrahium, homogeneity, necrosis, cystic changes, growth patterns, calcifications, enhancement patterns, MR signal intensity, and CT attenuation. RESULTS: Among the 29 cases of malignant tumors, seven cases were mandibular tumors including four chondrosarcomas, and 22 cases were extramandibular tumors. Malignant tumors of mandibular origin showed large masses with severe bone destruction and epicenter of mandible. Extramandiblular malignant tumors showed the epicenter out of the mandible and less severe bone destruction than mandibular tumors: Among the nine benign tumors, four cases were ameloblastomas which showed the well-defined masses and the expansion of the mandible, and four cases were extramandibular tumors which showed well-marginated extramandibular masses with no bone destruction. Among the eight infectious conditions, five cases were mandibular osteomyelitis with or without abscess formations, and the other three cases were infections from adjacent soft tissue or limited to the soft tissue. CONCLUSION: By careful observations of growth patterns, involvement of the masticator and adjacent spaces, bone changes, and epicenter of the lesions, one can discriminate a mandibular lesion from an extramandibular lesion. With this approach, it is thought to be easier to suggest a dignosis among a wide spectrum of masticator lesions.
Abscess ; Ameloblastoma ; Chondrosarcoma ; Magnetic Resonance Imaging* ; Mandible ; Muscles ; Necrosis ; Orbit ; Osteomyelitis ; Retrospective Studies

PURPOSE: The purpose of this study was to compare the accuracy of the implant master cast according to the type (pick-up, transfer) and the length (long, short) of the impression copings. MATERIALS AND METHODS: The metal master cast was fabricated with three internal connection type implant analogs (Osstem GS III analog), embedded parallel and with 10degrees of mesial angulation to the center analog. Four types of impression coping were prepared with different combinations of types (transfer, pick-up) and lengths (long, short) of the coping. The impressions were made using vinyl polysiloxane (one step, heavy + light body) with an individual tray, and 10 impressions were made for each group. Eventually, 40 experimental casts were produced. Then, the difference in the distance between the master cast and the experimental cast were measured, and the error rate was determined. The analysis of variance was performed using the SPSS (v 12.0) program (alpha = .05), and the statistical significance was set at P < .05. RESULTS: The ANOVA showed that the pick-up type impression coping exhibited a significantly lower error rate than the transfer type. However, no significant difference was observed with respect to the length of the impression coping. Additionally, no significant difference was observed between the parallel and mesial angulated groups. CONCLUSION: Within the limitations of this study, the pick-up type impression coping exhibited a more accurate implant master cast than the transfer type in parallel group. The accuracy of the implant master cast did not differ for different lengths of impression coping of at least 11 mm. Additionally, the accuracy of the implant cast was not different for the parallel and 10degrees mesial angulated groups.
Light ; Polyvinyls ; Siloxanes

No abstract available.
Classification* ; Female ; Hydatidiform Mole* ; Pregnancy ; Risk Factors*