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*

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

Alpasia cutis congenita is an anomaly characterized by absence of localized areas of the integument. The most common type of aplasia cutis congenita is Aplasia cutis congenita limited to the scalp, although other areas of the body may also be involved. We experienced a case of aplasia cutis congenita in a male newborn infant. The skin defects were extensive with symmetrical involvement of lower extremities. The multiple bullae were found on the both fingers and toes. No similar conditions and other associated congeital anomalies were found in the family membes of this particular case. The light microscopic examinaton of the denuded skin areas how absence of epidemis and the demis contain atrophic and hypoplastic adnexa. The bullae have a split within the dermis below lamina densa on electron microscopy. The skin defects were healed by supportive therapy for 4weeks.
Dermis ; Ectodermal Dysplasia* ; Epidermolysis Bullosa* ; Fingers ; Humans ; Infant, Newborn ; Lower Extremity ; Male ; Microscopy, Electron ; Scalp ; Skin ; Toes

Two cases of monochorial twins with twin-to-twin transfusion syndrome were presented. In both of two cases, cases, there were marked difference in hemoglobin levels between two identical twins but in one of two cases, the anemic two was more larger than the pletoric one in birth weight unusually. In one of two cases, both anemic infant and plethoric one survived, but in the other case, both succumbed.
Birth Weight ; Female ; Fetofetal Transfusion* ; Humans ; Infant ; Pregnancy ; Twins* ; Twins, Monozygotic

We report herein a case of vesicular pemphigoid in a 39 year-old female, who had 1 month history of multiple, pruritic vesicles with erythematous maeules on the whole body, especielly on the flexural surface. The histological findings showed subepidermal vesicle which contained many neutrophils. Direct immvnofluorescent study of perilesional skin revealed linear deposits of C along the dermoepidermal junction and indirect immunofluorescent study revealed linear deposits of immunoglobulin G and Cy along the dermoepidermal junction. Initially, dapsone was tried without any benefit but skin lesions were controlled by a combination therapy of prednisolone and cyclphosphamide.
Adult ; Dapsone ; Female ; Humans ; Immunoglobulin G ; Neutrophils ; Pemphigoid, Bullous* ; Prednisolone ; Skin

No abstract available.
Hernia*

BACKGROUND AND OBJECTIVES: Dual isotope myocardial SPECT, rest thallium-201/dipyridamole stress Tc-99m sestamibi is used to diagnose coronary artery disease. We examined predictive value of myocardial SPECT for the prognosis of patients having or suspected coronary artery disease. MATERIALS AND METHOD: We examined 692 patients referred for dipyridamole stress myocardial perfusion SPECT. Cardiac events (hard and soft events) were followed up with medical record review and telephone interview. Survival analysis and multivariate Cox proportional hazard model were used to find significant predictors and the incremental predictive value of myocardial SPECT. Patients with coronary angiography (n=246) were analyzed in separate group. RESULTS: There were 4 hard events and 3 soft events in 341 normal SPECT group (1.20%/yr). There were 5 hard events and 21 soft events in 351 abnormal SPECT group (4.69%/yr). Survival curve was separated between normal SPECT group and abnormal SPECT group (p<0.01). In univariate analysis, smoking, history of myocardial infarction, typical chest pain and SPECT findings were important variables. In multivariate analysis, SPECT result was the single most independent predictor. Large reversible perfusion abnormality predicted worse prognosis. In patients with coronary angiography, SPECT did not add statistically significant predictive value to the coronary angiography. CONCLUSION: Dipyridamole stress Tl-201/ MIBI dual isotope myocardial perfusion SPECT provided excellent prognostic information. Extent of reversible perfusion decrease was the independent predictor of future cardiac events.
Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Dipyridamole ; Humans ; Interviews as Topic ; Medical Records ; Multivariate Analysis ; Myocardial Infarction ; Perfusion ; Prognosis ; Proportional Hazards Models ; Smoke ; Smoking ; Tomography, Emission-Computed, Single-Photon*

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