Recently therapeutic efficacy of stomach cancer was greatly improved due to early diagnosis and irnproved diagnostic and therapeutic modalities. Especially in early gastric cancer, 5 year survival rate is near 100%. Recarrence of early gastric cancer after curative surgery is rarely reported. Recently authors experienced one case of recurrent stomach cancer arising from remmnant stomach 14 years after gastrectomy of EGC type I(m), so we reports it here with review of literatures.
Early Diagnosis ; Gastrectomy* ; Stomach Neoplasms* ; Stomach* ; Survival Rate

The patient was a 51 year-old woman suffering fraen dysphagia due to upper esoyhageal lye stricutue whieh had developed as a result of a suicide attempt 21 years ago. Shortly after that, she underwent feeding gastrostomy and has lived in the gastrostomy state for 2l years. After admission, she underwent a barium esophagoram which revealed a near total obstruction at the cricoid cartilage level. Bougie dilatation with American Dilation System was tried on day 3. But the spring tip marked guide wire which was to be used with the American Dilation System could not be passed through the stricuture. Therefore, we performed a bougie dilatation using angiographic guide wire M(H-AG-35in-150 cm) with success. On day 14, she underwent a barium esophagogram which revealed her improved condition, and she was discharged on day 16.
Barium ; Constriction, Pathologic* ; Cricoid Cartilage ; Deglutition Disorders ; Dilatation* ; Female ; Gastrostomy* ; Humans ; Lye* ; Middle Aged ; Suicide

Peritoneal tuberculosis is a disease rarely seen nowadays. Its symptoms are easy fatigue, abdominal distension, intermittent abdominal pain and ascites. Its onset is insidious, which si-mulates symptoms of peritonitis or carcinomatosis. Peritoneal tuberculosis should be considered in the differential diagnosis when a Patient's symptoms and signs are ascites, ovarian tumor, vague abdominal pain and abdominal distension with high serum level of CA 125, an antigenic determinant of epithelial ovarian cancers. We have recently experienced a case of peritoneal tuberculosis with markedly elevated serum level of CA 125 in 54 year-old woman and report our case with a brief review of the literature.
Abdominal Pain ; Ascites ; Carcinoma ; Diagnosis, Differential ; Fatigue ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; Peritonitis ; Peritonitis, Tuberculous*

The pre-transplantation goal of the urologist is the optimization of urinary tract condition. Therefore, urologic surgery may be needed before or after renal transplantation. We analyzed the results of urologic surgery performed because of de novo urologic diseases. Between January 1986 and January 2001, 281 patients underwent renal transplantation, and 23 urologic surgical procedures were performed on 21 transplant recipients before or after renal transplantation because of de novo urologic diseases. By review the major reasons for urologic surgery in recipients were polycystic kidney diseases, vesicoureteral reflux, and dysfunctional voiding disorders. Nineteen surgical corrective procedures were done average 2.9 months before transplantation. The mortality rate was 10.5%. Four patients underwent urologic surgery at an average 57.5 months after transplantation. We highlight the fact that patients with uremia are vulnerable to surgical complications, and conclude that more intensive longterm urologic follow-ups should be conducted on recipients.
Adult ; Child ; Female ; Follow-Up Studies ; Humans ; Kidney/abnormalities ; Kidney Diseases/surgery/*therapy ; Kidney Transplantation/*methods ; Male ; Middle Aged ; Nephrectomy ; Polycystic Kidney Diseases/pathology/therapy ; Postoperative Complications ; Preoperative Care ; Research Support, Non-U.S. Gov't ; Time Factors ; Urologic Diseases/surgery ; Urologic Surgical Procedures/*methods ; Vesico-Ureteral Reflux/therapy

The increasing use of the laparoscopic surgery in the management of gynecologic disease resulted in an increasing incidence of complication and the development of new complications. Incisional hernia through laparoscopic trocar site is an unusual complication of laparoscopy. A rare form of port-associated complication is omental herniation. This report describes a case of omental herniation through a 10-mm subumbilical incision following uneventful laparoscopic surgery.
Female ; Genital Diseases, Female ; Hernia ; Incidence ; Laparoscopy* ; Surgical Instruments

OBJECTIVE: The factors that influence the prognosis of patients with hemifacial spasm (HFS) treated by microvascular decompression (MVD) have not been definitely established. We report a prospective study evaluating the prognostic factors in patients undergoing MVD for HFS. METHODS: From January 2004 to September 2006, the authors prospectively studied a series of 293 patients who underwent MVD for HFS. We prospectively analyzed a number of variables in order to evaluate the predictive value of independent variables for the prognosis of patients undergoing MVD. The patients were followed-up at regular intervals and divided into as cured and unsatisfactory groups based on symptom relief. Uni- and multivariate analyses were performed using logistic regression models. RESULTS: A total 273 of 293 (94.2%) patients achieved symptom relief within one year after the operation. Intraoperatively, the indentation of the root exit zone was observed in 259 (88.5%) patients. Uni- and multivariate analyses revealed that the symptoms at postoperative 3 months (p<0.001) and indentation of the root exit zone (p=0.036) were associated with good outcomes. CONCLUSION: The intraoperative finding of root exit zone indentation will help physicians determine the prognosis in patients with HFS. To predict the prognosis of HFS, a regular follow-up period of at least 3 months following MVD should be required.
Follow-Up Studies ; Hemifacial Spasm ; Humans ; Logistic Models ; Microvascular Decompression Surgery ; Multivariate Analysis ; Prognosis ; Prospective Studies

OBJECTIVE: We measured current perception threshold (CPT) with transcutaneous electrical nerve stimulation (TENS) to prove the selective increment of the threshold of C sensory fiber and to determine onset time and duration of effect for application of TENS. METHOD: TENS were applied to fifteen control volunteers for 20 minutes on hand three times per week for 2 weeks duration. The CPT was tested at the distal interphalangeal joint of the second finger with 5 Hz, 250 Hz, and 2,000 Hz in frequency, respectively. The test was repeated immediately and 30 minutes after cessation of TENS. These tests were performed on the first, eighth, and fifteenth day on application of TENS. RESULTS: The baseline CPT of C fiber was 32.7 +/- 6.4 10 2 mA, A gamma fiber 23.2 +/- 9.4 10(-2) mA, and A beta fiber 83.9 +/- 18.1 10(-2) mA. At 30 minutes after cessation of TENS in the fifteenth day, the CPT of C fiber increased markedly and that of A gamma fiber increased a little. The CPT of A beta fiber didn't increase for 2 weeks. CONCLUSION: With application of TENS, the threshold of C and A gamma fibers selectively increased, especially 30 minutes after removal of TENS application. This effect was outstanding after 2 weeks' application.
Fingers ; Hand ; Joints ; Median Nerve* ; Nerve Fibers, Unmyelinated ; Transcutaneous Electric Nerve Stimulation* ; Volunteers

OBJECTIVE: This study was designed to evaluate the compressibility of heel pads in patients with diabetes mellitus. METHOD: The subject were twenty control subjects and 20 patients with diabetes mellitus diagnosed at least 5 years previously, over the age of 40. The thickness of heel pads was measured by ultrasonography without pressure and with pressure of 1 kg, 2 kg and 3 kg at the line connecting the second toe and the mid-heel point. The ratio of the thickness of the heel pad with pressure of 1 kg, 2 kg, 3 kg and without pressure, R1 (ratio of the thickness of heel pad with 1 kg and without pressure), R2 (2 kg) and R3 (3 kg), was compared between controls and diabetics. RESULTS: There was no significant difference of heel pad thickness between controls and diabetics without pressure in sole. The diabetics had greater ratio, less compressibility than controls (p<0.05). The ratio of the control group was R1; 0.67+/- 0.07, R2; 0.53+/-0.07 and R3; 0.45+/-0.07, whereas that ratio of the diabetic group was R1; 0.80+/-0.09, R2; 0.68+/-0.09 and R3; 0.58+/-0.09. CONCLUSION: The evaluation of compressibility of heel pad of the patients with diabetes mellitus compared with the control group will help to make a treatment of heel pain or discomfort.
Diabetes Mellitus* ; Heel* ; Humans ; Toes ; Ultrasonography

OBJECTIVE: To establish the objective method of diagnosing the myofascial pain syndrome through diagnostic ultrasound and pathology. METHOD: Hamstring muscles of 7 female house rabbits, weighing 2.5~3.0 Kg, were studied. The existence of nodule was confirmed by palpation and through diagnostic ultrasound. A horizontal length, vertical length, thickness, and an area of hyperechoic region were measured. Hyperechoic regions were biopsied and stained with hematoxylin-eosin. RESULTS: All examined rabbits had muscular nodules in the medial hamstring. Characteristic increase of echogenecity was observed in the medial hamstring muscles. Some uneven hyperechoic areas were seen in the lateral hamstring muscles. Fatty degeneration and giant round cells were observed in the medial hamstring where the echogenecity was increased. The giant round cells were observed only in the lateral hamstring. CONCLUSION: Increased echogenecity of the medial hamstring muscle is probably contributed by muscles cells with fatty degeneration and giant round cells, and some portions of hyperechogenecity of lateral hamstring requires further study.
Female ; Humans ; Muscles ; Myofascial Pain Syndromes* ; Palpation ; Pathology ; Rabbits ; Ultrasonography*

OBJECTIVE: The ultrasonographic (US) findings of the sternoocleidomastoid muscles (SCM) in patients with congenital torticollis were studied to evaluate the correlation between the US findings and outcome of physical theraphy. METHOD: We studied 52 patients diagnosed as congenital muscular torticollis. We evaluated the thickness, mass, echogenicity and echotexture of both SCM muscles. The US findings of the SCM muscles were divided into 5 grades according to the severity. The physical theraphy included heat theraphy and passive stretching of involved muscle. The outcomes of the treatment were evaluated by physical examination and follow-up US examination. RESULTS: Neck rotation of lesion site comparing to non-lesion site was improved significantly from 83.0+/-16.5% to 94.9+/-7.16% and lateral flexion from 77.9+/-18.1% to 90.5+/-12.4% after the treatment. In 20 US follow-up cases, thickness ratio of the involved SCM muscle decreased significantly from 177.8+/-46.2% to 158.3+/-83.1%. The therapeutic effect tends to be low with higher grades of the US findings. But, there were no significant statistical correlation between age and treatment outcome. CONCLUSION: The US findings of the SCM muscles had a significant correlation with the outcome and the duration of treatment.
Follow-Up Studies ; Hot Temperature ; Humans ; Muscle Stretching Exercises ; Muscles ; Neck ; Physical Examination ; Torticollis* ; Treatment Outcome ; Ultrasonography