Malignant gastrointestinal stromal tumors (GISTs) are rare non-epithelial, mesenchymal neoplasms of the gastrointestinal tract that metastasize or recur in 30% of patients who undergo surgical resection with curative intent. A 59-year-old man visited our hospital for an examination of a palpable mass in the left abdomen. Fourteen months prior to his visit, the patient underwent gastric wedge resection to remove a GIST of the gastric cardia. At the time of surgery, no evidence of metastatic disease was observed and the pathological interpretation was a high-risk GIST. A follow-up computed tomography scan of the abdomen revealed a partially necrotic solid mass (9.8 x 7.6 cm) and enhancing mass in the spleen (2.3 cm). On exploration, multiple masses were found in the liver, greater omentum, and mesentery. Here, we report a case of recurring GIST of the stomach that metastasized to the spleen. To the best of our knowledge, few reports of metastasis to the spleen exist.
Abdomen ; Cardia ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Liver ; Mesentery ; Middle Aged ; Neoplasm Metastasis ; Omentum ; Spleen ; Stomach

Osteopetrosis is an uncommon hereditary bone disorder whose prominent radiologic feature characterized by increased bone density. The authors reported a 7-year-old male patient who referred from local dental clinic for dental problems such as early exfoliation of deciduous teeth(#54,73,83) and delayed eruption of permanent teeth(#31,41,36,46). The patient appeared as a poorly developed. Dental X-ray films showed early exfoliation of deciduous teeth, delayed eruption of permanent teeth, and rampant caries. Lateral view of skull demonstrated increased opacity of calvarium, facial bones, and skull base. Generally the skeletal density is greatly increased throughout all bones. Facial CT showed poor development of paranasal sinuses and mastoid air cells. No hematopoietic and neurologic complications such as anemia, thrombocytopenia, blindness and deafness were found. Also mental retardation was not found. The final diagnosis of this case was a osteopetrosis tarda. Sometimes patient with osteopetrosis tarda may be developed dental problems prior to severe systemic symptoms. The dentist can be the first clinician to see the patient. It is very important for the dentist to have the knowledge of the osteopetrosis and to care the patient's dental problems to prevent complication such as osteomyelitis of jaws.
Anemia ; Blindness ; Bone Density ; Child ; Deafness ; Dental Clinics ; Dentists ; Diagnosis ; Facial Bones ; Growth Disorders ; Humans ; Intellectual Disability ; Jaw ; Male ; Mastoid ; Osteomyelitis ; Osteopetrosis* ; Paranasal Sinuses ; Skull ; Skull Base ; Thrombocytopenia ; Tooth ; Tooth Eruption ; Tooth, Deciduous ; X-Ray Film

Anti-Bacterial Agents ; Drainage ; Fever ; Humans ; Orthognathic Surgery ; Wound Infection ; Wounds and Injuries

Anti-Bacterial Agents ; Humans ; Mandible ; Maxilla ; Orthognathic Surgery

PURPOSE: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. METHODS: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients' characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. RESULTS: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn't be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. CONCLUSION: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn't be found on CXR to be verified, which helped us to could accurately evaluate patients.
Contusions ; Early Diagnosis ; Emergencies ; Hemothorax ; Humans ; Lacerations ; Medical Records ; Pneumothorax ; Retrospective Studies ; Rib Fractures ; Subcutaneous Emphysema ; Thoracic Injuries ; Thoracic Wall ; Thorax ; Tomography, X-Ray ; Vital Signs

The endoscopic fine needle aspiration cytology may add to the diagnostic accuracy of endoscopic biopsy and brush cytology. It is also of particular value in submucosal, infiltrative and ulceronecrotic tumors. Endoscopic fine needle aspiration cytology was done with sclerotherapy needle(23 gauge) in. the 17 patients with submucosal tumor(18 cases), extrinsic compression(2 cases), infiltrative gastric cancer(one case) and cancer of the ampulla of Vater(one case) on the upper gastrointestinal endoscopy. Endoscopic fine needle aspiration cytology established the diagnosis in 6 cases(submucosal tumor of the stomach; 2 cases, submucosal tumor of the duodenum; one case, extrinsic mass of the duodenum; one case, infiltrative cancer of the stomach; one case, and the cancer of ampulla of Vater; one case) of 17 cases. There were negative results for malignancy in 7 cases and material insufficiency in 4 cases. Five cases of the positive results with endoscopic fine needle aspiration cytology were not diagnosed with endoscopic forceps biopsies. There was no complication. We conclude that endoscopic fine needle aspiration cytology is a simple and safe technique and is of particular value in submucosal tumor, extrinsic compression of the upper gastrointestinal tract by tumor, and infiltrative gastric cancer.
Ampulla of Vater ; Biopsy ; Biopsy, Fine-Needle* ; Diagnosis* ; Duodenum ; Endoscopy, Gastrointestinal ; Humans ; Sclerotherapy ; Stomach ; Stomach Neoplasms ; Surgical Instruments ; Upper Gastrointestinal Tract

No abstract available.
Lymphoma, Large-Cell, Anaplastic

PURPOSE: Locally advanced rectal cancer may require an intraoperative decision regarding curative multivisceral resection (MVR) of adjacent organs. In bulky tumor cases, ensuring sufficient distal resection margin (DRM) for achievement of oncologic safety is very difficult. This study is designed to evaluate the adequate length of DRM in multiviscerally resected rectal cancer. METHODS: A total of 324 patients who underwent curative low anterior resection for primary pT3-4 rectal cancer between 1995 and 2004 were identified from a prospectively collected colorectal database. RESULTS: Short lengths of DRM (< or =1 cm) did not compromise essentially poor oncologic outcomes in locally advanced rectal cancer (P = 0.736). However, especially in rectal cancers invading adjacent organs, DRM of less than 2 cm showed poor survival outcome. In 5-year and 10-year survival analysis of MVR, a shorter DRM (<2 cm) showed 41.9% and 30.5%, although a longer DRM (> or =2 cm) showed 72.4% and 60.2% (P = 0.03, 0.044). In multivariate analysis of MVR, poorly differentiated histology, ulceroinfiltrative growth of tumor, and short DRM (<2 cm) were significant factors for prediction of poor survival outcome, although short DRM was not significantly related to local and systemic recurrence. CONCLUSION: In locally advanced rectal cancer of pT3-4, a short length of DRM (< or =1 cm) did not compromise essentially poor oncologic outcome. In rectal cancers invading adjacent organs and requiring MVR, a shorter DRM (<2 cm) was found to be related to poor survival outcome.
Achievement ; Humans ; Multivariate Analysis ; Prospective Studies ; Rectal Neoplasms

No abstract available.
Impetigo* ; Pregnancy*

OBJECTIVE: Kyphoplasty and vertebroplasty are two minimally invasive procedures for osteoporotic vertebral compression fractures. The purpose of this retrospective study was to compare the radiological findings and clinical outcomes between two procedures. METHODS: Osteoporotic vertebral fractures were treated in 76 vertebrae, using kyphoplasty (n=35 vertebrae) and using vertebroplasty (n=41 vertebrae). Fractured vertebral bodies were diagnosed by correlating the clinical symptoms with radiologic study. The responses of pain symptoms were measured by a self-reported Visual Analog Scale (VAS) score. Plain X-rays were checked preoperatively and postoperatively at admission and 6 months. The vertebral body height and kyphotic angle were measured to assess the reduction of the sagittal alignment. RESULTS: The mean pain scores were decreased significantly for both procedures postoperatively, but there were no significant differences between two groups. Kyphoplasty led to a significant reduction of the vertebral body height and improvement of kyphotic angle. There were no neurological deficits after kyphoplasty, but one patient experienced paraparesis after vertebroplasty. During the 6 months follow-up both procedures provided stabilization of the sagittal alignment. CONCLUSION: Kyphoplasty and vertebroplasty are considered effective minimally invasive techniques for the stabilization of osteoporotic vertebral body fractures, leading to a statistically significant reduction in pain. Kyphoplasty significantly restore sagittal alignment. Also, complications and the incidence of bone cement leakage are significantly lesser than vertebroplasty. Therefore, kyphoplasty seems to be reasonable procedure for osteoporotic vertebral body compression fractures when medical treatment fail.
Body Height ; Follow-Up Studies ; Fractures, Compression* ; Humans ; Incidence ; Kyphoplasty* ; Kyphosis ; Osteoporosis ; Paraparesis ; Retrospective Studies ; Spine ; Vertebroplasty* ; Visual Analog Scale