PURPOSE: Primary small bowel cancer is rare. In many cases, the diagnosis is difficult especially in jejunum and ileum, confirmed in advanced state with poor prognosis. This study was intended to clarify the characteristics of primary small bowel cancer. MATERIAL AND METHOD: We have reviewed 24 patients with primary small bowel cancer that have been operated at the Department of Surgery, hospital from Jan. 1990 until Dec. 1996. The clinical feature, diagnostic method, location and histologic finding of tumor, prognosis were analyzed. RESULTS: 1. The ratio of male to female was 1:1.18. The mean age was 53 years and the most prevalent age group was 6th decade (13 cases, 54.1%). 2. The most common primary site was jejunum (9 cases), followed by duodenum (8 cases) and ileum (7 cases). Leiomyosarcoma occurred most frequently in jejunum, adenocarcinoma in duodenum, and lymphoma in ileum. 3. The most common symptom was abdominal pain (66.7%), followed by anemia (54.2%), palpable mass (50%). 4. The accuracy rate of preoperative diagnosis or suspicion was 45.8%, and diagnostic measures were endoscopy in duodenum, small bowel series and/or abdominal CT. in jejunum and ileum. 5. Curative resection was performed in 14 cases (58.3%), and the cancer in which palliative resection was undertaken most frequently was leiomyosarcoma. 6. The mean follow-up period of 23 cases except 1 was 33 months, during this time 9 cases were dead, of whom 5 cases had leiomyosarcoma. CONCLUSION: Frequently, small bowel cancer is difficult in diagnosis, confirmed in late stage. High degree of suspicion and more endeavor to discover it is important and needed to bring a better result.
Abdominal Pain ; Adenocarcinoma ; Anemia ; Diagnosis ; Duodenum ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Ileum ; Jejunum ; Leiomyosarcoma ; Lymphoma ; Male ; Prognosis ; Tomography, X-Ray Computed

PURPOSE: Suction ring is needed to fix the cornea during LASIK procedure. But if we choose the suction ring inappropriately, we meet the various problems such as conjunctival edema, conjunctival hemorrhage, ocular pain, and prolongation of operation time. To investigates various factors affecting the thickness of suction ring(1-4) in LASIK procedure. METHODS: We performed LASIK procedure by using SCMD microkeratome and VISX STAR laser on 398 eyes from Dec. 1996 to Feb. 1999. We compared difference on pachymetry, keratometry, corneal diameter, spherical equivalent according to the thickness of suction ring and analyzed these factors with One-Way ANOVA test. RESULTS: The results are that keratometry affected size of suction ring significantly. The flap size and hinge size are affected by size of suction ring significantly, but others did not show significant results. CONCLUSIONS: These results suggest that we need to choose the size of suction ring according to keratometry during LASIK procedure for decreasing various complications.
Cornea ; Edema ; Hemorrhage ; Keratomileusis, Laser In Situ* ; Suction*

The authors reported one case of toxic epidermal necrolysis that occurred in the carbamazepine treatment in a 47-year old male patient with aggressive organic mental disorder. This case developed toxic epidermal necrolysis while taking carbamazepine with a dose of 600mg/day. Toxic epidermal necrolysis did not improve after discontiuation of carbamazepine. We reviewed incidence and the natural history of toxic epidermal necrolysis.
Alcoholism ; Carbamazepine ; Cluster Analysis ; Neurocognitive Disorders ; Humans ; Incidence ; Male ; Middle Aged ; Natural History ; Stevens-Johnson Syndrome*

No abstract available.
Hand*

No abstract available.
Breast Neoplasms* ; Breast*

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

Brunner's gland adenoma(or Brunneroma) is clinically relevant tumor-like lesion of the duodenum which is composed of submucosal Brunner's gland tissue. Since the first case by autopsy was described by Cruveihier in l935, there have been less than 190 reports in the world literature, Brunner's gland adenoma is an extremely rare entity that accounts for only 10.6% of benign duodenal tumors, which are themselves relatively rare representing 0.008% of all surgical and autopsy specimens. The clinical manifestation of this tumor are non-specific gastrointestinal complaints, such as bloating or epigastric pain, and tumor often gives rise to melena or obstruction, It is postulated that this tumor are hamartomas rather than true neoplasm. However, they undergo rarely malignant transformation. We report on a case of a large pedunculated Brunner's gland adenoma, which was successfully polypectomized.
Adenoma* ; Autopsy ; Duodenum ; Hamartoma ; Melena

PURPOSE: Oncogen or growth factor receptor such as phospholipase C isoenzyme gamma-1 (PLC gamma-1), epidermal growth factor receptor (EGFR), and Her-2/neu which related with tyrosin kinasemay and then regulating vell proliferation may have a role as prognostic factors for breast cancer. MATERIAL AND METHODS: With assumption that expression of PLC gamma-1, EGFR and Her-2/neu oncogene has close relationship with prognosis of breast cancer, 59 breast cancer patients who were operated upon at Korea University Hospital during a period of 6 years starting June 1988 to May 1994 were selected for this study. This study was carried out by comparing between expression of PLC gamma-1, EGFR and Her-2/neu oncogene and patient's survival rate. These expression were also compared with TNM system, estrogen and progesterone receptor and at same time these expressions were compared with each other to see whether there are any relationship among these expression. RESULTS: Expression of PLC gamma-1, EGFR and Her-2/neu were present in 42% (25/59), 46% (27/59) and 20% (12/59). The expression of PLC gamma-1 was closely related with the expression of EGFR (p<0.05) and Her-2/neu (p<0.05), but there were no relationship between the expression of PLC gamma-1 and hormonal receptors and TNM stage (p>0.05). The expression of EGFR was closely related with the expression of Her-2/neu (p<0.05) and hormone receptors (p<0.05), but there were no relationship between the expression of EGFR and pathologic TNM stage (p>0.05). The expression of Her-2/neu was not closely related with hormone receptors and TNM stage except axillary lymph node metastasis. There were close relationship between overall and disease free survival and PLC gamma-1 and Her-2/neu. But EGFR had only related with disease free survival rate. CONCLUSION: In conclusion, the expression of PLC gamma-1, EGFR and Her-2/neu oncogene in human breast cancer may be useful prognostic factors independently and it may potentiated its individual value as a prognostic factors if use them together.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Epidermal Growth Factor* ; Estrogens ; Humans* ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Phospholipases* ; Prognosis ; Receptor, Epidermal Growth Factor* ; Receptors, Progesterone ; Survival Rate ; Type C Phospholipases*

Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

Tumarkin's otolithic crisis refers to drop attacks that are an unusual manifestation of Meniere's disease. It has been proposed that these drop attacks result from mechanical deformation of the otolithic organs related to the endolymphatic hydrops that occurs in Meniere's disease, as revealed by MRI with intratympanic gadolinium enhancement. Here we report a patient with Tumarkin's otolithic crisis in whom inner-ear MRI with intratympanic gadolinium administration during the acute attack did not reveal the presence of endolymphatic hydrops.
Endolymphatic Hydrops* ; Gadolinium ; Humans ; Magnetic Resonance Imaging* ; Meniere Disease ; Otolithic Membrane* ; Syncope