Colorectal cancer is treated primarily by surgery. The goal of surgery is to completely remove the tumor. Surgery for carcinoma of the colon is aimed at removing the tumors with an adequate margin by a wide excision of the tumor-bearing area and associated lymphatics, with attention to the blood supply to the segment and creation of anastomosis without tension. Both rectal and colon cancers are resected for the purpose of cure and prevention of spread and local or pelvic recurrence. The operations generally employed for cancers above the rectum include right colectomy, transverse colectomy, left colectomy, anterior resection, subtotal colectomy, and total colectomy. More limited resections are occasionally performed for palliation in patients with distant metastasis. The survival benefits from the no-touch technique and radical lymphadenectomy with high ligation are still controversial. In rectal cancer, 2 ㎝ is sufficient for the distal resection margin. Several reports have demonstrated improvement in local recurrence rates and cancer-specific survival rate through TME (total mesorectal excision). The technique of chemosensitized irradiation was successful in down staging the tumors and in reducing the tumor size. Preoperative chemoradiation therapy and coloanal anastomosis enables the sphincter-preserving operation more frequently. The rectum, genitourinary structures, and the pelvic autonomic nervous system are very closely related. The urinary and sexual function can be preserved by nerve-sparing operation for rectal cancer. The anorectal function might be improved by colonic pouch operation. Transanal excision or trananal endoscopic microsurgery are advocated for the definitive treatment of small, exophytic, well differentiated, mobile lesions. Resection of hepatic or pulmonary metastasis in cases with-out contraindications improves the survival.
Autonomic Nervous System ; Colectomy ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; Ligation ; Lymph Node Excision ; Microsurgery ; Neoplasm Metastasis ; Rectal Neoplasms ; Rectum ; Recurrence ; Survival Rate

No abstract available.
Animals ; Ligation* ; Neuralgia* ; Rats* ; Rhizotomy* ; Spinal Cord* ; Spinal Nerves*

No abstract available.
Coal* ; Mucous Membrane*

No abstract available.
Cardioplegic Solutions* ; Heart Diseases* ; Heart* ; Hemodynamics* ; Humans

No abstract available.
Stomach Neoplasms*

We report the clinical evolution of two elderly male patients with extramammary Paget's disease who were treated with radiotherapy. Both cases primarily involved the scrotum and penile root, and were not associated with any underlying or visceral malignancy. The total doses administered were 6000 cGy and 3000 cGy, respectively. A good clinical response was achieved in both cases. No major side effects were observed. The patients are being followed for any signs of recurrence and have been completely asymptomatic to date
Aged ; Humans ; Male ; Paget Disease, Extramammary ; Radiotherapy* ; Recurrence ; Scrotum

We report a case of tuberculosis verrucosa cutis in a 33-year-old male patient who presented with mild itching verrucous plaque over the perineum. The Mantoux test revealed a positive reaction. The histophathologic picture consists of slight hyperkeratosis, irregular ac:anthosis overlying an inflammatory iafitrate in the dermis. Tuberculous granulomas with caseation necrosis were seen in the dermis. Tuber clebacillus was demonstrated. The patient was treated with Isoniazid, Rifampicin, and Pyrazine made for 6 months. To date, the skin lesions have markedly improved.
Adult ; Dermis ; Granuloma ; Humans ; Isoniazid ; Male ; Necrosis ; Perineum ; Pruritus ; Rifampin ; Skin ; Tuberculosis*

No abstract available.
Evaluation Studies as Topic* ; Hoarseness*

Ovulation induction in hypothalamic amenorrhea using gonadotropin- releasing hormone(GnRH) pulse therapy is complicated by widely variant patient responses ranging from anovulation to multiple pregnancy. Route of administration(intravenous vs subcutaneous), pulse therapy, GnRH dose, infusion interval, or hormone preparation may contribute. We evaluated the bioactivity of 4 GnRH preparations(Relisorm,Serono; Lutrelef,Ferring; Factrel,Ayerst; GnRH,Sigma) in a rat anterior cell bioassay. Dispersed rat anterior pituitary cells were placed for 48 hrs at 5x105 cells/well, washed and incubated with GnRH. The GnRH was diluted according to the manufacturer's culture medium(10(-12) to 10(-5)M). GnRH stimulated immunoreactive luteinizing hormone(LH) production was assested in culture medium after 4 hrs by radioimmunoassay(RIA). A linear dose-response relationship was exhibited by all preparations from 10(-10) to 10(-7)M. Msximal LH production was 249+/-24 ng/ml/4hrs(mean+/-SEM) and was not different among the preparations tested(ANOVA, p>0.05). The minimal effective dose of GnRH was 10-10M for all preparations(basa1=27+/-4ng/ml/4hrs:mean+/-SEM). No significant differences were noted for MED, or dose-response slope(p<0.05, ANOVA and slope test for parallelism, respectively). In addition, bioactive LH and immuno and bioactive follicular stimulating hormone(FSH) dose responses were confirmed. We concluded that the principal variability of patient response seen with GnRH pulse therapy cannot be attributed to the bioactivity of these commercial GnRH preparations. But rather, most of the variability is due to the inherent individualism in patient response or other factors of the treatment protocol.
Amenorrhea ; Animals ; Anovulation ; Biological Assay ; Clinical Protocols ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Lutein ; Ovulation Induction ; Pregnancy ; Pregnancy, Multiple ; Rats

Nicotine is a water-soluble alkaloid extracted from tobacco plants, and most frequently encountered in snuff, chewing tobacco, cigarettes, cigars and pipe tobacco or in a limited number of pesticides. Nicotine overdose or poisoning might be serious or fatal and lead to death; caused by cardiovascular arrest, respiratory muscle paralysis, and/or central respiratory failure due to its toxic effect. Suicide by nicotine ingestion has been rarely reported due to emetic response. We present a case of suicidal nicotine poisoning. A 56-year-old man was found dead and the postmortem examination revealed no injury or disease. We confirmed a high concentration of nicotine in the toxicological test. Through scene investigation, we determined this case as a suicidal nicotine poisoning.
Autopsy ; Eating ; Humans ; Middle Aged ; Nicotine* ; Pesticides ; Poisoning* ; Respiratory Insufficiency ; Respiratory Paralysis ; Suicide ; Tobacco ; Tobacco Products ; Tobacco, Smokeless