The authors observed clinically typical case of unilateral coloboma of the optic disc. This patient, 5 years old Korean boy, visited to our clinic with the chief complaints of visual disturbance and intermittant exotropia of left defecting eye. The optic disc was enlarged about 2.5 times of normal optic disc diameter excavated about 7.0 Diopters in depth. The vision of colombomatous left eye was 20/50(n.c.) but the cause of defective vision was not evaluated certainely whether it might be due to coloboma itself or slight posterior subcapsular opacity of the lens.
Child, Preschool ; Coloboma* ; Exotropia ; Humans ; Male ; Optic Nerve*

PURPOSE: An adequate pain control is one of important factors for obtaining good outcomes in the ambulatory basis of hemorrhoidectomy. There have been many methods for pain control after hemorrhoidectomy such as narcotics, various kinds of analgesics, etc. The aim of this study is to compare intraoperative internal anal sphincter injection of Ketorolac tromethamine and other two conventional methods for pain control. METHODS: A total of 56 patients with hemorrhoid grade III or IV underwent surgery between May and October 1999, and prospectively assigned to three groups in the consecutive order. The group was divided in Group 1: [Ketorolac tromethamine (Tarasyn) 60 mg intrasphincteric injection intraoperatively and 30 mg IM/prn?10 mg po/6hrs], Group 2: [No intraoperative injection and maintain pain control with Tarasyn 30 mg IM/prn/10 mg po/6hrs], and Group 3: [No intraoperative injection and maintain pain control with Pethidine (Demerol) 50 mg IM/prn and Ibuprofen 400 mg/Paracetamol 500 mg/Codeine 20 mg (Myprodol) po/8hrs]. The post operative data and pain scoring was performed on the questionnaire with Point box scale (BS-11) and Behavioral rating scale (BRS-6) each 24 hours during 5 days after surgery. RESULTS: There are 22 patients in the Group 1, 16 in the Group 2 and 18 patients in the Group 3. The median age of the Group 1 is 42.5, Group 2, 44.5 and Group 3, 45 years. The pain score on the first day after surgery in group 1 was significantly lower than group 2 (p<0.05) in the both pain scoring scale but was no differences between group 1 and 3. On the fifth day after surgery group 3 was significantly lower than both group 1 and 2 in the point box scale (p<0.05). The urinary retention rate and the day of first bowel movement after surgery show no differences among three groups (p>0.05). CONCLUSIONS: Intraoperative internal anal sphincter injection of Ketorolac tromethamine shows a better pain control than conventional methods in early postoperative period. Therefore it might be helpful for patients to go home on the day after surgery, and strong pain killer to control pain after discharge will be needed.
Anal Canal* ; Analgesics ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Ibuprofen ; Ketorolac Tromethamine* ; Ketorolac* ; Meperidine ; Narcotics ; Postoperative Period ; Prospective Studies ; Surveys and Questionnaires ; Tromethamine ; Urinary Retention

No abstract available.
Carcinoembryonic Antigen* ; Colorectal Neoplasms* ; Humans

No abstract available.
Bone Density*

No abstract available.
Arthroplasty, Replacement, Hip* ; Bone Density* ; Hip*

PURPOSE:The aim of this study is to assess the potential role of PET in patients with unexplained rising CEA levels after curative resection of colorectal cancer or for differential diagnosis of the result by conventional radiologic study. METHODS:18 patients with abnormal CEA levels and normal results of conventional methods of tumor detection and 7 patients who needed differential diagnosis after conventional X-ray were studied with PET. The PET results were compared with pathologic findings or conventional radiologic and clinical follow-up for 6 months. RESULTS:PET showed increased uptake in 17 of 25 patients. Using PET in 18 patients with elevated carcinoembryonic antigen levels, 12 patients showed increased uptake of FDG. Among them, 11 positive findings were turned out to be a true recurrence and there was one false positive finding. Six patients with elevated carcinoembryonic antigen levels showed normal PET scan. But conventional X-ray or repetition of PET confirmed the recurrence in 2 patients among them. Using PET in 7 patients for differential diagnosis of conventional X-ray, 3 patients showed hot uptake of FDG and all of them were turned out to be a true recurrence. There were no abnormal findings in 4 patients but one patient among them showed a hepatic recurrence. It was confirmed by abdominal MRI. Overall, sensitivity was 82.4% and specificity was 87.5% CONCLUSIONS:When conventional examinations are normal except CEA elevation or equivocal, PET is a valuable imaging tool for the detection of recurrence.
Carcinoembryonic Antigen ; Colorectal Neoplasms* ; Diagnosis, Differential ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Positron-Emission Tomography* ; Recurrence ; Sensitivity and Specificity

PURPOSE: The aim of this study is to describe the safety and efficacy of radiofrequency ablation (RFA) in the treatment of unresectable liver metastasis from colorectal cancer. METHODS: From January 1999 to December 2000, we undertook 48 RFA procedures in 36 patients with unresectable metastatic liver tumor from colorectal cancer. RFA was performed either via celiotomy (n=23) or using a percutaneous approach (n=25) under ultrasound guidance using a LeVeen needle electrode and a RF 2000 generator. Patients were followed with spiral computed tomographic scans at 1 week after RFA. RESULTS: RFA was performed in 15 patients with synchronous hepatic metastasis and 21 with metachronous hepatic metastasis. The mean tumor size was 3.1 cm (range; 0.5~7.2 cm). In 2 patients, complete ablation failed due to anatomic tumor location. Nine patients (25%) exhibited post RFA complications (9 cases of fever, 8 of abdominal pain, and 1 of hematoma) which showed spontaneous resolution and there was no treatment-related death. At a mean follow up of 10.1 months, 12 patients (33.3%) had recurred in the liver and 3 (8.6%) at the RFA site, while 16 (44.4%) remained clinically free of disease. CONCLUSION: Although RFA is a relatively safe procedure in patients with unresectable hepatic metastasis from colorectal cancer, the possible development of new metastatic disease after RFA is currently a limitation in this form of treatment. Further study on the efficacy of RFA versus other treatment modalities is needed.
Abdominal Pain ; Catheter Ablation* ; Colorectal Neoplasms* ; Electrodes ; Fever ; Follow-Up Studies ; Humans ; Liver ; Needles ; Neoplasm Metastasis* ; Ultrasonography

PURPOSE: The aim of this study was to evaluate the rate and pattern of recurrence of rectal cancer as well as analyze the risk factors affecting recurrence following resection with curative intent. METHODS: 460 patients underwent curative resection for adenocarcinoma of the rectum at our clinic from 1994 to 1998. Among these, 132 patients (29.1%) whose recurrence was confirmed by clinical and radiologic examination or reoperation were studied retrospectively. The risk factors that determined the recurrence patterns were analysed with univariate and multivariate analyses. RESULTS: The mean time to recurrence was 22.0 months. The locoregional recurrence rate was 5.7% (25/440). The systemic recurrence rate was 18.4% (81/440). 12 patients (2.7%) had two or more sites of recurrence at the time of diagnosis. The most common locoregional recurrence was a pelvic recurrence (2.3%; 10/440), followed by anastomosis (2.0%; 9/440) and presacral (0.9%; 4/440). The most common site of systemic recurrence was the liver (7.0%; 31/ 440), followed by the lung (5.9%; 26/440) and peritoneum (3.2%; 14/440). The mean time from recurrence to death was 16.0 months. Logistic regression analysis demonstrated that nodal metastasis (P=0.002), vascular invasion (P=0.027), elevated CEA level (P=0.011), and microscopic invasion to the lateral margin (P=0.008) were risk factors for postoperative recurrence. When the recurrence patterns were compared to stage, the systemic recurrence rate was 3.0% in stage I, 15.3% in stage II, and 28.9% in stage III. The locoregional recurrence rate was 3.0% in stage I, 6.0% in stage II, and 6.8% in stage III. CONCLUSION: Even though an excellent local control was obtained following curative resection of rectal cancer, the main cause of recurrence was a systemic failure in advanced rectal cancer. More effective systemic chemotherapy is required for the prevention of systemic recurrence.
Adenocarcinoma ; Diagnosis ; Drug Therapy ; Humans ; Liver ; Logistic Models ; Lung ; Multivariate Analysis ; Neoplasm Metastasis ; Peritoneum ; Rectal Neoplasms* ; Rectum ; Recurrence* ; Reoperation ; Retrospective Studies ; Risk Factors

Accidents, Occupational ; Accidents, Traffic ; Brain ; Diagnosis ; Facial Bones ; Female ; Frontal Bone ; Frontal Sinus ; Headache Disorders ; Humans ; Male ; Maxilla ; Nose ; Postoperative Complications ; Sex Ratio ; Surgery, Oral

PURPOSE: The treatment of colorecatal cancer depends primarily upon the stage, and whether or not the regimen of adjuvant therapy can also be decided through this staging. In fact, the clinicopathologic prognostic factors are well known. In addition to these prognostic factors, the importance of molecular biological prognostic factors has also come to light. METHODS: This study was devised to analyze the recurrence pattern and the survival rate and correlate them with the prognostic factors in a group of surgically treated colorectal cancer patients, who were recruited from 1989 to 1998 at the Severance Hospital, Yonsei Uinversity College of Medicine. The survival curves were analyzed according to the Kaplan-Meier method, and the Cox regression hazard model was used to analyze the prognostic factors influencing the survival rates. RESULTS: A total of 1973 patients were recruited, and among them 1848 (93.7%) had undergone a resection with 1643 (89.1%) having a curative resection. The overall follow-up time after surgery was 60.5+/-35.4 months and 1945 (98.6%) patients were confirmed to have either survived or died. The overall recurrence rate was 386/1643 (23.5%). Of these, the local recurrence rate was 86/386 (22.2%), the systemic recurrence rate was 236/386 (61.1%), and both local and systemic recurrence rates were 50/386 (12.9%). The overall 5 year survival rate was 61.5%, and according to the TNM stage, the survival rate was 84.3% for stage 1, 79.2% for stage 2, 61.5% for stage 3, and 31.5% for stage 4. Multivariate analysis indicated that the TNM stage, the number of lymph nodes involved, the gross appearance of the tumor, the positive lateral margin, vascular invasion, the preoperative CEA level (higher than 5ng/ml), and rectal cancer were significant prognostic factors for the 5 year survival rate. CONCLUSION: Patient with ulceroinfiltrative, poorly differentiated, rectal cancer and the positive lateral resection margin, vascular invasion etc. had a poor survival rate after a curative resection for colorectal cancer. In addition to these clinicopathologic prognostic factors, an investigation into the molecular biological prognostic factors is also needed.
Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Proportional Hazards Models ; Rectal Neoplasms ; Recurrence* ; Survival Rate*