Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and a relatively small subset of GISTs whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement is infrequent in GISTs, wide margins with routine lymph node dissection may not be required. Various techniques of limited resection for duodenal GISTs have been described depending on the site and the size of the tumors. In this study, we report two cases of GIST involving the third and fourth portion of the duodenum successfully treated by segmental duodenectomy with end-to-end duodenojejunostomy. This technique should be considered as a treatment option for GIST located at the third and fourth portion of the duodenum.
Duodenum ; Gastrointestinal Stromal Tumors ; Lymph Node Excision ; Lymph Nodes

Bowens disease is generally regarded as a premalignant dermatosis. If untreated, 3% to 5% of patients may develop squamous cell carcinoma. However, sebaciou carcinoma arising from Bowens disease is very rare. We presented a case of quarnous cell carcinoma and sebaceous circ s disease in a 68 year-old male. He had multiple bowenoid skin lesi nsties. A bean-sized nodule as developed on the bowenoid lesion of the he had a large yellow crust.ed exudative tumor on the Rt. thigh. We took a biopsy specimen of these three discrete lesions. The nu lipid stain of frozen section revealed Bowens disease, squarnous concllnoma arising from Bowen on the trunk and extremi Rt. lower abdomen. Almost of routine histology and carcinoma, and sebaceous carcinoma, respectively.
Abdomen ; Aged ; Biopsy ; Bowen's Disease ; Carcinoma, Squamous Cell* ; Frozen Sections ; Humans ; Male ; Skin ; Skin Diseases ; Thigh

No abstract available.
Meningitis*

No abstract available.
Neoplasm Metastasis ; Prognosis

Recent studies suggest that apolipoproteins may be better predictor of ischemic heart disease than are plasma lipids, such as total cholesterol and high density lipoprotein cholesterol(HDL-C). To examine this hypothesis, plasma levels of major lipids and major apolipo-proteins were measured and their derivatives were calculated in 30 male patients with ischemic heart disease(16 angina pectoris and 14 old myocardial infarction) and 30 age-matched male healthy controls. Plasma levels of lipids were obtained by conventional methods and apolipoproteins by Rocket immunoelectrophoresis. Levels of HDL-C, HDL2-cholesterol(HDL2-C), and apolipoprotein-AII, and ratios of HDL-C/total cholesterol, HDL2-C/total cholesterol, and apolipoprotein-AI/apolipoprotein-B were lower in the group of patients than in controls. Levels of low density lipoprotein cholesterol(LDL-C) and apolipoprotein-B, and ratios of lDL-C/HDL-C and apolipoprotein-AI/apolipoprotein-AII were higher in the group of patients. There were no statistically significant differences in the levels of total cholesterol and apolipoprotein-AI between the two groups. Stepwise discriminators analysis showed that apolipoprotein-B and apolipoprotein-AII were better discriminators than plasma lipids for identifying those with ischemic heart disease. One could correctly classify 78% of the cases by using the levels of the two apolipoproteins. By using the level of apolipoprotein-B, one could correctly classify 73% of the cases. There were no correlations between the levels of total cholesterol and HDL-C in the controls whereas there were positive correlations between the levels in the group of patients. In conclusion, this study showed that apolipoprotein-B was the best single discriminator for identifying the patients with ischemic heart disease, followed by apolipoprotein-AII.
Angina Pectoris ; Apolipoproteins A* ; Apolipoproteins* ; Cholesterol ; Heart ; Humans ; Immunoelectrophoresis ; Lipoproteins ; Male ; Myocardial Ischemia* ; Plasma* ; Risk Factors*

No abstract available.
Child* ; Humans ; Seizures, Febrile* ; Spinal Puncture*

We report a case of multiple cutaneous focal mucinosis in a 22 year-old male, who presented with multiple, asymptomatic, nodular lesions on the left upper trunk and left arm which had persisted for about one year. They were 2 to 17 mm in size, firm, yellowish, dome-shaped elevated, slightly movable papules or nodules which were distributed over the area of the left C3-7 and TI-3 sensory dermatomes. The histopathologic findings showed homogeneous mucinous material in the upper dermis. The material was confirmed to be hyaluronic add by, alcian blue stain. Some of the lesions showed improvement with intmlesional injection of triamcinolone acetonide. Such an entity, to the best of our knowledge, has not yet been reported.
Alcian Blue ; Arm ; Dermis ; Humans ; Male ; Mucinoses* ; Mucins ; Triamcinolone Acetonide

PURPOSE: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. MATERIALS AND METHODS: 118 patients (M: F=66:52, 62.7+/-10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6+/-5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. RESULTS: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. CONCLUSION:: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.
Death ; Electrocardiography ; Heart Failure ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Myocardial Ischemia ; Perfusion ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Tomography, Emission-Computed, Single-Photon*

Between Aug. 1985 and Dec. 1995, among 18 patients with trauma of anterior urethra 7 were treated by an endoscopically guided primary urethral realignment under intravenous injection of analgesics. Of the 5 partial ruptures, 3 had excellent results without stricture from 2 months to 4 years (mean 13 months) and resulted in 23-37ml/sec maximal uroflow rate. Then 2 had focal urethral stricture, which could be easily treated with endoscopic internal urethrotomy. Before endoscopically guided primary urethral realignment was done, 6 urethral ruptures without pelvic bone fracture partial rupture 3 cases, complete rupture 3 cases) were performed suprapubic cystostomy and urethroplasty stepwise. We experienced urethral stricture in 6 cases, then performed endoscopic internal urethrotomy and urethroplasty. 4 cases of urethral rupture with pelvic bone fracture partial rupture 1 case, complete rupture 3 cases) were performed suprapubic cystostomy and primary urethroplasty, then there were urethral stricture in all 4 cases. This method offers simpler and more effective than conventional methods without pelvic bone fracture under intravenous injection of analgesics.
Analgesics ; Constriction, Pathologic ; Cystostomy ; Endoscopy ; Humans ; Injections, Intravenous ; Pelvic Bones ; Rupture* ; Urethra ; Urethral Stricture

No abstract available.
Hernia*