Colorectal carcinoma in patients under 40 years and over 70 years of age is unusual but not rare. The prognosis of these two groups, compared with remainder of patients, is thought to be unfavorable. From Jan. 1981 to Dec. 1997, 541 patients with primary colorectal cancer who were treated by surgical resection were analyzed retrospectively. They were divided into three age groups according to the age at admission, i.e. under 40 years, over 70 years and between 40 and 69 years(control group). Among three age groups, sex ratio, tumor characteristics(size, location , depth of invasion, lymph node metastasis, liver metastasis, peritoneal metastasis, histopathologic classification, stage, DNA ploidy pattern), serum CEA level and survival were compared and analyzed. The results were as follows: 1) In the young patient group(52 cases), female predominence, large tumor size, high proportion of mucinous adenocarcinoma in histopathologic classification, more frequent metastasis to regional lymph node, frequent peritoneal metastasis and high incidence in tumor location at transverse colon were noted(p<0.05). 2) In the elderly group(69 cases), deep invasion of tumor(T4) was noted (p<0.05). In addition, among them, concomittent diseases were presented in 25 patients(36%). They were diabetes(8), cardiac arrhythmia(4), old myocardial infarction(2), liver cirrhosis(5), COPD(3), previous cancer(3). 3) The 5-year survival rates of the young patient group and that of elderly patient group were lower than that of the other(p<0.01). 4) There was no significant differences in liver metastasis, tumor stage, DNA ploidy pattern, serum CEA level among three age groups.
Adenocarcinoma, Mucinous ; Aged* ; Classification ; Colon, Transverse ; Colorectal Neoplasms* ; DNA ; Female ; Humans ; Incidence ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Ploidies ; Prognosis ; Retrospective Studies ; Sex Ratio ; Survival Rate

We built the hypothesis that the hypertrophic callus formation is mediated by beta-endorphin that stimulates secretion of GH and increase circulation growth factor activity in head injury patient. We classified 4 groups such as 5 normal person(control), group I;5 patients with only fracture, group II;5 patients with fracture and head injury, group III; 5 patients with only head injury, group IV. We obtained the samples of serum from each group at 0, 2, 4, 6, 8 weeks after trauma and assessed the serum level of GH, GHRH, somatostatin. The serum level of GH was statisticallyu higher in group III, IV than group I, II. There was not significant difference in serum level of GHRH. The serum level of somatostatin was higher in group II, III, IV than group I, but there was no statistical significance in each group. GH has a important role in hypertrophic callus formation in severe head injury patients, but there was no evidence that the mechanism is mediated by beta-EndorphinGHRH & somatostatin-GH-GF-1, beta-FGF axis. There may be a another mechanism in increasing GH that was stimulated by beta-endorphin in thalamus and lateral ventricle, and it should be necessary for further evaluation of it.
Axis, Cervical Vertebra ; beta-Endorphin ; Bony Callus ; Craniocerebral Trauma* ; Head* ; Humans ; Lateral Ventricles ; Somatostatin ; Thalamus

It is challenging for orthopedic surgeons to diagnose pain at the ulnar aspect of the wrist due to the small and complex anatomical structures involved. Ulnar-sided wrist pain can also result from tendon problems, including extensor carpi ulnaris tendon and flexor carpi ulnaris tendon. Disorders of the extensor carpi ulnaris tendon include subluxation, dislocation, stenosing tenosynovitis, and tendinopathy. Unlike the extensor carpi ulnaris tendon which is prone to subluxation, dislocation and stenosing tenosynovitis from passing through as sheath, a flexor carpi ulnaris tendon is unsheathed, and calcific tendinitis and crystal deposition disease can occur at the distal tendinous portion of the flexor carpi ulnaris tendon.
Dislocations ; Orthopedics ; Surgeons ; Tendinopathy ; Tendon Entrapment ; Tendons* ; Tenosynovitis ; Wrist*

Drug-eluting stent implantation is an effective treatment for coronary artery disease, yet unexpected serious complications during stent implantation are possible. A 70-year-old man with unstable angina presented with a left main bifurcation lesion. Two drug-eluting stents were successfully deployed at the left main bifurcation lesion by the mini-crush technique under intravascular ultrasound guidance. However, after removal of the wire and intravascular ultrasound catheter, the stent of the proximal left circumflex artery was damaged and shortened at the distal edge. We used a looping wire technique to cross the injured stent and we successfully re-dilated the damaged portion of the stent. Finally, we deployed an additional drug-eluting stent at the left circumflex artery over the damaged stent. Our case illustrates the importance of gentle handling of devices during coronary intervention. Furthermore, interventionists should keep in mind the role of intravascular ultrasound when treating this kind of serious complication.
Aged ; Angina, Unstable ; Angioplasty ; Arteries ; Catheters ; Coronary Artery Disease ; Drug-Eluting Stents ; Humans ; Stents ; Ultrasonography

Multifocal motor neuropathy (MMN) is an uncommon, asymmetric motor neuropathy. As MMN is a treatable disorder, its differentiation from lower motor neuron disease is important. Evidence of conduction block (CB) or positive IgM anti-GM1 is considered one of important markers for the diagnosis. However, some patients with atypical MMN have no detectable CB or anti-GM1 antibody. We experienced a case of MMN with focal nerve enlargement on ultrasound. Ultrasound can be a valuable tool in supporting the diagnosis of MMN.
Diagnosis ; Humans ; Immunoglobulin M ; Motor Neuron Disease ; Peripheral Nervous System Diseases ; Ultrasonography

No abstract available.
Diagnosis ; Myotonia ; Polyneuropathies ; Relaxation

Methods: Patients with and without TCLH were assigned to groups A and B, respectively. POSEH between the two groups was compared morphometrically and symptomatically. The risk factors for symptomatic and morphometric POSEH in BESS were identified. Results: The morphometric POSEH was greater in group B, and the difference was significant (p =0.019). The incidence of symptomatic POSEH was lower in group A with 4.6% (5/109) than in group B with 9.5% (9/95); however, the rate was not significantly different (p =0.136). The morphometric POSEH was classified into two small (hG1 and hG2) and large (hG3 and hG4) and were compared between groups A and B, and the difference was significant (p =0.02). In the multivariable logistic regression, nonuse of TCLH (p =0.004) and preoperative diagnosis of stenosis (p =0.016) were variables found to be significant risk factors of morphometric POSEH. Conclusions Severe compression of the thecal sac by POSEH is more common in patients without TCLH. The risk of hematoma formation was higher when bilateral decompression was needed and the cut bone surface was more exposed.

Cervical endonetriosis with cystic change is extremely rare lesion. We experienced onecase of cervical endometriosis in 33 year old woman, who had no symptoms, so we reprot thecase and brief review of literatures.
Adult ; Endometriosis* ; Female ; Humans

Most osteosarcomas arise spontaneously, but rarely they may be secondary to other benign osseous conditions and may occur following irradiation. Postradiation sarcoma of bone is approximately 5.5 percent of all osteogenic sarcoma. Diagnosis is possible when a sarcoma arising after long latent period(more than 3 years) in irradiated bone and the bone is normal or benign osseous lesion at the time of irradiation. The spontaneously arising osteogenic sarcomas are distribute mainly in the knee region, but postradiation sarcoma arise in any bones, such as long bone of the extremity, pelvic bone, vertebra, craniofacial bone and shoulder girdle bone. Recently we experienced a case of postradiation osteosarcoma of the pelvic bone who received radiation therapy for carcinoma of the uterine cervix 20 years ago.
Cervix Uteri ; Diagnosis ; Extremities ; Female ; Knee ; Osteosarcoma* ; Pelvic Bones* ; Sarcoma ; Shoulder ; Spine

None of the reports of delayed infection mentioned a latent period exceeding 13 months. we report an infection that developed 18 months after implantation of an absorbable plate. A 16-year-old adolescent girl had undergone reduction and fixation with an absorbable plate for Lefort I and zygomaticomaxillary complex fractures 18 months prior at our hospital. In her most recent hospital visit as an outpatient, abscess was observed in periocular area. Computed tomography revealed sinusitis with an abscess above the infraorbital rim. Wound culture yielded methicillin-resistant Staphylococcus aureus . Despite conservative treatments, wound state did not improve. Therefore, our department decided to perform surgery. Absorbable plate had been mostly absorbed but remained a bit. Bony depression of infraorbital rim and mucosal exposure of maxillary sinus anterior wall were observed. After the surgery, the patient recovered. We believe that the reason the wound infection and sinusitis manifested at the same time is because of several factor such as alcohol abuse, smoking, and mucosal exposure of maxillary sinus anterior wall. Absorbable plate takes 9 months to 3 years to be completely absorbed, thus we suggest studies with a follow-up of at least 3 years be undertaken to determine the outcomes of patients with many risk factors.
Abscess ; Absorbable Implants ; Adolescent ; Alcoholism ; Depression ; Female ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Maxillofacial Injuries ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Outpatients ; Prosthesis-Related Infections ; Risk Factors ; Sinusitis ; Smoke ; Smoking ; Wound Infection ; Wounds and Injuries