No abstract available.
Exostoses, Multiple Hereditary* ; Sarcoma, Synovial*

No abstract available.
Central Nervous System*

PURPOSE: Malignant bowel obstruction caused by recurrent gastric cancer must be treated appropriately to improve the effects of treatment and to prolong survival. We reviewed the surgical treatments for malignant bowel obstruction caused by recurrent gastric cancer. MATERIALS AND METHODS: The subjects were patients with malignant bowel obstruction caused by recurrent gastric cancer and these patients were treated by surgical procedures at our hospital from 1998 to 2008. The patients were treated by resection, ostomy or bypass. The success of treatment was decided when the patients were able to tolerate more than a liquid diet. RESULTS: 42 patients were treated 46 times by surgical procedures. Resection was done12 times, ostomy was done 24 times and bypass was done 10 times. The hospital stay and the period to liquid diet after the operation were shorter in the ostomy group. The post operative morbidity rate was 21.7% and the post operative death rate was 8.7%. There was no significant difference in survival according to the type of surgery. CONCLUSION: Ostomy is good choice for selected patients because it has a shorter hospital stay and period to liquid diet. There was no significant difference in survival according to the type of surgery because curative resection is difficult to perform in patients with malignant bowel obstruction.
Diet ; Humans ; Length of Stay ; Ostomy ; Stomach Neoplasms

OBJECTIVE: Incompetent internal os of cervix is one of the most common causes of midtrimester abortion in which interventions such as, transvaginal cerglage and transabdominal cervicoisthmic cerclage (TCIC) have been performed to prolong pregnancy. Transabdominal cerclage is beneficial in treating patients with cervices that are either extremely short, congenitally deformed, deeply lacerated after operative delivery, or markedly scarred because of previously failed transvaginal cerclage procedures. Due to technical difficulties and the fact that a cesarean section is necessary for delivery, has not been a procedure easily adopted. The purpose of our study was to compare the effectiveness of selected Modified McDonald cerclage (MTVC) and TCIC was compared in patients who had history of a previously failed transvaginal cerclage in other hospital. MATERIALS AND METHODS: Pregnancy outcomes of 13 patients who underwent TCIC from November 1997 to January 2002 and those of 28 patients who underwent MTVC from January 2000 to January 2002 were compared. Statistical analysis was done using Chi-square test and Mann-Whitney. RESULTS: The fetal salvage rates for total 13 cases of TCIC and 28 cases of MTVC were 100% (13/13) and 85.7% (24/28), respectively. The fetal salvage rates between these two groups were not statistically different. The mean gestational age at the time of operation in TCIC group was 13.15 (+/-1.63) weeks, mean gestational weeks delayed until delivery was 23.85 (+/-3.24) weeks and mean fetal body weight was 2780.77 (+/-667.33) gm. Comparably, the mean gestational age at the time of operation in MTVC group was 15.00 (+/-2.05) week, mean gestational weeks delayed until delivery was 9.96 (+/-6.65) week and mean fetal body weight was 2530 (+/-1071.26) gm. CONCLUSION: In patients who had a history of failure of TVC, the effectiveness of TCIC and MTVC had no statistical significance. Treatment with MTVC should be considered since TCIC is technically difficult and requires cesarean section.
Cervix Uteri* ; Cesarean Section ; Cicatrix ; Female ; Fetal Weight ; Gestational Age ; Humans ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second

Gastrointestinal stromal tumor (GIST) were previously known as smooth muscle tumor like leiomyoma or leiomyosarcoma. Most of them were histologically spindle cell tumors, usually of mesenchymal origin. Stromal tumors account for about 1% to 2% of gastric malignant tumor, and the most important characteristics is their indolent, slow-growing nature, rendering most common definitions of malignancy invalid and inapplicable. The tumors are generally found deep within the stroma and submucosa, and only about half have an intragastric component, detectable by radiography, endoscopy or endoscopic ultra-sonography (EUS). Especially EUS is a valuable technique for diagnosing GIST. We experienced a 35-year-old female patient who complained right upper quadrant pain. She was diagnosed as subserosal stromal tumor by gastrofiberscopy, EUS, abdominal CT and operation. We report a case of gastric subserosal stromal tumor with a review of relevant literatures.
Adult ; Endoscopy ; Female ; Gastrointestinal Stromal Tumors ; Humans ; Leiomyoma ; Leiomyosarcoma ; Radiography ; Smooth Muscle Tumor ; Stomach* ; Tomography, X-Ray Computed

OBJECTIVE: The purpose of this study was to investigate the effectiveness of further successful pregnancies and prognosis after delivery where the band was not removed from a transabdominal cervicoisthmic cerclage (TCIC) after a first successful pregnancy. The candidates of TCIC were those who were diagnosed with incompetent internal os of cervix (IIOC) and either had failed to maintain pregnancy after undergoing transvaginal cerclage (TVC) or could not undergo TVC due to cervical abnormalities. METHODS: During the period from May of 1991 until November of 2002, there were total 20 cases in which the band was not removed after previous TCIC, followed by a first successful pregnancy. RESULTS: In the 20 patients who had undergone TCIC, the average age, average gestational age at the time of operation, average number of previous pregnancy, average number of surviving fetus, average number of preterm delivery, and average number of fetal death were 32 years old, 12.8 weeks, 5.4, 0.2, 2 and 2.2, respectively. Cesarean section was performed at an average gestational age of 37.1 weeks in which the average birth weight was 2903 g in the first born child among 19 patients. In the following pregnancies, the average age of the patients were 34 years old in which there were 17 successful deliveries out of 20 cases where the average gestational period was 35.4 weeks and an average weight of 2661 g. There was an average of 22.5 months between the time of the first and second delivery. CONCLUSION: When the location and tension of the band had been confirmed after the first delivery in a total of 20 patients, there was a high successful delivery rate of 85% (17/20) in the next pregnancy. In this study, there was no evidence to support the complications reported in previous studies of difficulty in removal of trophoblastic tissue after abortion, dysmenorrhea, and increase in infertility associated with non removal of bands.
Adult ; Birth Weight ; Cervix Uteri* ; Cesarean Section ; Child ; Dysmenorrhea ; Female ; Fetal Death ; Fetus ; Gestational Age ; Humans ; Infertility ; Pregnancy* ; Prognosis ; Trophoblasts

Intravenous leiomyomatosis is a rare benign vascular tumor defined as the extension into venous channels of a histologically benign smooth muscle tumor arising either from a uterus or from the walls of uterine vessels, and about 10% spread to the heart. The treatment of choice is complete resection of the tumor. Hormonal therapy should be considered in cases of unresectable residual tumor. A 46-year-old woman was admitted for abdominal discomfort and pain. She was found to have intravenous leiomyomatosis of the uterus with extension into inferior vena cava and right atrium. The patient underwent surgery employing simultaneous sternotomy and laparotomy. Radical excision was achieved using cardiopulmonary bypass. We herein describe a patient in whom complete removal of intravenous leiomyomatosis with cardiac extension was successfully performed.
Cardiopulmonary Bypass ; Female ; Heart ; Heart Atria ; Humans ; Laparotomy ; Leiomyomatosis* ; Middle Aged ; Neoplasm, Residual ; Smooth Muscle Tumor ; Sternotomy ; Uterus ; Vena Cava, Inferior

Tuberculosis is common disease in developing countries manifested by multi-organ involvement. Although the incidence of tuberculosis has been reducing recently due to the advancement of anti-tuberculosis chemotherapy, improvement of public health, and early diagnosis, the rate is still higher in developing countries. The diagnasis of colonic tubcrculosis is difficult due to its frequency, vague manifestation, and difficulty in confirming the disease process. Fortunately, the advent of flexible colonoscopy has provided an opportunity to confirm the diagnosis of colonic tuberculosis, however biopsy can frequently leveal false negative results. A-27-year-old man was admitted with a 2 week history of rectal bleeding. He complained of anorexia, abdominal pain, and weight loss. Routine laboratory tests and chest X-ray findings were within normal limits, with the exception of left pleural thickening. A colonoscopy showed irregular and small, multiple, and shallow polypoid mucosal lesions in the ascending colon and multiple ulcers in the transverse colon. Multiple colonic biopsies suggested tuberculosis. After three months of prirnary anti-tuberculosis medica tion, the patient showed slightly improved coiono- scopic findings. Follow-up colono- scopic findings revealed more aggrevation and chest X-ray findings showed multiple patch consolidation in the left lung field. Primary anti-tuberculosis medication was stopped and substituted for secondary anti-tuberculosis medication. When clinical and colonoscopic methods are found to be compatible with intestinal tuberculosis in countries with a high prevalence of colonic tuberculosis, a therapeutic trial with an antituberculosis agent is usually considered. In a failed therapeutic trial, considerations must be made not only to other inflammatory bowel diseases such as crohn's disease, but also to multi-drug resistance tuberculosis.
Abdominal Pain ; Anorexia ; Biopsy ; Colon* ; Colon, Ascending ; Colon, Transverse ; Colonoscopy ; Crohn Disease ; Developing Countries ; Diagnosis ; Drug Resistance, Multiple ; Drug Therapy ; Early Diagnosis ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Lung ; Prevalence ; Public Health ; Thorax ; Tuberculosis* ; Ulcer ; Weight Loss

Neonatal diabetes mellitus (NDM) is a rare disease requiring insulin treatment. Its treatment is primarily focused on maintaining adequate glycemic control and avoiding hypoglycemia. Although insulin pump therapy is frequently administered to adults and children, there is no consensus on the use of insulin pumps in NDM. A 10 day-old female infant was referred to us with intrauterine growth retardation and poor weight gain. Hyperglycemia was noted, and continuous intravenous insulin infusion was initiated. However, the patient's serum glucose levels fluctuated widely, and maintaining the intravenous route became difficult within the following weeks. Continuous subcutaneous insulin infusion with an insulin pump was introduced on the twenty-fifth day of life, and good glycemic control was achieved without any notable adverse effects including hypoglycemia. We suggest that the insulin pump is a safe and effective mode for treating NDM and its early adoption may shorten the length of hospital stays in patients with NDM.
Blood Glucose ; Diabetes Mellitus* ; Female ; Fetal Growth Retardation ; Humans ; Hyperglycemia ; Hypoglycemia ; Infant ; Infant, Newborn ; Insulin Infusion Systems* ; Insulin ; Length of Stay ; Rare Diseases ; Weight Gain

No definitive recommendation is available concerning optimal antithrombotic therapy in pregnant women with a mechanical heart valve. The purpose of the current study was to evaluate the clinical results of nadroparin treatment with respect to pregnancy outcome and maternal complications. From 1997 to 2005, 31 pregnancies were reviewed in 25 women. Nadroparin (7,500 U, twice daily) was used in 23 pregnancies between 6 and 12 weeks of gestation and close-to-term only, and coumarin derivatives were used with aspirin at other times. Eight pregnant women treated with coumarin derivatives throughout pregnancy were compared to evaluate the safety and efficacy of nadroparin. No maternal death or bleeding complication occurred in either of the two groups, and frequencies of maternal thromboembolism including valve thrombosis (8.7% vs. 12.5%, p>0.05) were similar. However, the frequencies of live born (91.3% vs. 50%, p=0.01) and healthy babies (90.4% vs. 25%, p<0.01) were significantly higher, and the fetal loss rate was significantly lower (8.7% vs. 50%, p=0.01) in the nadroparin-treated group. Regarding the efficacy and safety of antithrombotic treatment in pregnant women with prosthetic heart valves, nadroparin treatment during the first trimester is an acceptable regimen and produces better results than coumarin derivatives.
Treatment Outcome ; Thrombosis/etiology/*prevention & control ; Pregnancy Outcome ; Pregnancy Complications, Cardiovascular/*etiology/*prevention & control ; Pregnancy ; Nadroparin/*administration & dosage/*adverse effects ; Hydrocephalus/chemically induced ; Humans ; Heart Valve Prosthesis/*adverse effects ; Heart Valve Diseases/etiology/*prevention & control ; Female ; Coumarins/administration & dosage ; Adult