No abstract available.
Hamartoma*

Gastric metastasis from ovarian carcinoma is extremely rare and the prognosis for patients is poor. We report a case of multimodal treatment improving the survival time of a patient with gastric metastasis from ovarian cancer. A 73-year-old woman with known serous ovarian cancer was admitted to the hospital due to epigastric pain and dyspepsia. On esophagogastroduodenoscopy, a protruding mass was noted at the gastric antrum. She underwent distal gastrectomy with Billroth I anastomosis and lymph node dissection, including the para-aortic lymph nodes. The final pathology revealed gastric metastasis from ovarian serous adenocarcinoma. In this case, after cytoreductive surgery, chemotherapy was performed each time a recurrence was diagnosed, and remission was accomplished. She survived for 108 months after the first diagnosis of the metastatic tumor in the stomach. Multimodal treatment of metastatic lesions since the first diagnosis allowed the patient to survive longer than those in previous reports.
Adenocarcinoma ; Aged ; Combined Modality Therapy* ; Diagnosis ; Drug Therapy ; Dyspepsia ; Endoscopy, Digestive System ; Female ; Gastrectomy ; Gastroenterostomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis* ; Ovarian Neoplasms* ; Pathology ; Prognosis ; Pyloric Antrum ; Recurrence ; Stomach

PURPOSE: Althoughpancreas injury is rare in abdominal trauma,it posesa challengeto the surgeon because its clinicalfeaturesare not prominentand the presence of main duct injurycannot be easily identified by imaging studies. Furthermore, severe pancreas injuries require a distal pancreatectomy or a pancreaticoduodnectomy which are associated considerable morbidity and mortality. We reviewed the clinical features of and outcomes for patients with pancreas injury. METHODS: For 10 years from Jan. 2001 to Dec. 2010, thirty-four patients were diagnosedas having pancreas injury by using an explo-laparotomy. Patients successfully treated bynon-operative management were excluded. Patients were divided into early (n=18) and delayed surgery groups (n=11) based on an interval of 24hours between injury and surgery. The clinical features of and the outcomes for the patients in both groups were compared. RESULTS: Males were more commonly injured (82.4% vs.17.6%). The mean age was 37.2 years. The injury mechanisms included vehicle accidents (62.9%, 22/34), assaults (20%, 7/34), and falls (11.4%, 3/34)). The head and neck of the pancreas was most commonly injured, followed by the body and the tail (16, 12, and 6 cases). Of the 34 patients, 26 (76.5%) patients had accompanying injuries. Grade 1 and 2 occurred in 14 (5 and 9) patients, and grade 3, 4, and 5 occurred in 20 (16, 3, and 1) patients. The early and delayed surgery groups showed no difference in surgical outcomes. Two patients with grade 3 in the early surgery group died after surgery,one due tomassive hemorrhage and the other due to septic shock. Of the five patients initially managed non-operatively,three developed peripancreatic necrosis and two developed pseudocyst. All five patients were successfully cured by surgery. CONCLUSION: All cases of pancreas injury in this study involved blunt injury, and accompanying injury to major vessels or the bowel was the major cause of mortality. Surgery delayed for longer than 24 hours after was not associated with adverseoutcomes.
Head ; Hemorrhage ; Humans ; Male ; Neck ; Necrosis ; Pancreas ; Pancreatectomy ; Shock, Septic ; Wounds, Nonpenetrating

Duplication of the alimentary tract is an unusual congenital anomaly which may occur at any level, from the oral cavity to the rectum. Gastric duplication cyst is quite rare and most of them are presented in infancy with the sypmtoms of vomiting, abdominal pain, weight loss, gastrointestinal bleeding resulting from partial or complete obstruction. Some cases have not been diagnosed until adult when duplication cyst is not large enough to cause acute obstruction in infancy. Our case is more unusual in the aspect of its presence in adult and its nature resembles huge pancreatic pseudocyst. A 18-year man came to our hospital with complaint of epigastric pain for three days. A gastrofiberoscopy revealed a round protruding mass with smooth surface of normal mucosa at the fundus and computed tomography of the abdomen revealed the presence of 6.0 X 6.0 cm sized cystic mass between posterior wall of stomach and pancreas, and another 2.0 x 2.0 cm sized mass in ant. wall of stomach, which were regarded as mutiple pancreatic pseudocysts in perigastric region. Endoscopic retrograde cholangiopancreatography did not disclose any pancreatic ductal abnormality or communication with the cyst. Endoscopic ultrasonography showed anechoic cystic mass under 3rd layer of stomach wall, which was removed by surgical resection. Postoperative pathologic examination disclosed multiple gastric duplications.
Abdomen ; Abdominal Pain ; Adult ; Ants ; Cholangiopancreatography, Endoscopic Retrograde ; Endosonography ; Hemorrhage ; Humans ; Mouth ; Mucous Membrane ; Pancreas ; Pancreatic Ducts ; Pancreatic Pseudocyst* ; Rectum ; Stomach ; Vomiting ; Weight Loss

Nocardia species are aerobic, gram-positive, filamentous, partially acid-fast actinomycetes which are found worldwide in soil and decaying organic plant matter. When they infect human beings, they generally enter through the respiratory tract and then disseminate systemically. Rarely has a primary infection occurred as the result of direct inoculation. Isolation of Nocardia from clinical specimens and identification of species are difficult. But, with the introduction of new genetic technologies, reports of novel species of Nocardia have increased. We describe a case of cutaneous nocardiosis caused by Nocardia takedensis in an 87-year-old woman who was diagnosed by bacterial culture and 16S ribosomal RNA sequencing. N. takedensis has been described as a new species. This report describes the first clinical isolate of N. takedensis from a skin specimen in Korea.
Actinobacteria ; Aged, 80 and over ; Female ; Humans ; Korea ; Nocardia Infections* ; Nocardia* ; Plants ; Respiratory System ; RNA, Ribosomal, 16S ; Skin ; Soil

Cutaneous and systemic plasmacytosis (CSP) is a rare disorder of unknown etiology characterized by cutaneous polyclonal plasma cell infiltrates associated with various extracutaneous involvement and polyclonal hypergammaglobulinemia. Here, we report on a 54-year-old male patient with chronic renal insufficiency who presented with disseminated reddish-brown macules and plaques on the face and trunk. In our evaluation, he was found to have lymphadenopathy, polyclonal hypergammaglobulinemia; benign plasma cell infiltration involving the skin, bone marrow, and retroperitoneal area; and renal amyloidosis. To the best of our knowledge, this is the first reported case of CSP associated with renal amyloidosis.
Amyloidosis* ; Bone Marrow ; Humans ; Hypergammaglobulinemia ; Lymphatic Diseases ; Male ; Middle Aged ; Plasma Cells ; Renal Insufficiency, Chronic ; Skin

OBJECTIVES : Adenotonsillar hypertrophy is one of the principal causes associated with snoring, sleep apnea, and restless sleep. These sleep-disordered breathing (SDB) is associated with hyperactivity, rebellious behavior, aggressiveness, enuresis, inattention, social withdrawal, and learning difficulties. The purpose of this study was to assess the impact of adenotonsillar hypertrophy on attention deficit hyperactivity symptoms and sleep-related symptoms in children by standard tests. METHODS : Children aged 5 through 15 years old, a total of 65 who were scheduled for Tonsillectomy and Adenoidectomy, were studied. The control group consisted of 30 healthy children of the same age. In both groups, attention-deficit hyperactivity dis-order (ADHD) was evaluated by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The degree of inattention, hyperactivity and sleep-related symptoms was evaluated by Korean ADHD Rating Scales (K-ARS), ADHD diagnostic system (ADS) and pediatric sleep questionnaire. The K-ARS and sleep questionnaire were completed by the parents of the children. RESULTS : Acording to K-SADS-PL, 23 subjects out of 65 subjects in the patient group and 2 subjects out of 30 subjects in the control group were diagnosed with ADHD. According to sleep questionnaires, the patient group reported significantly more problems than the control group. The patients had significantly higher cumulative questionnaire scores than the control group. In linear regression analysis, the cumulative score of sleep questionnaire was associated with inattention subscale scores, hyperactivity/impulsivity subscale scores and the total score of K-ARS, and also with the response time and the standard deviation of response time of ADS. In relation to ADHD, the patient group had significantly higher ADHD scores in K-ARS inattention subscale and significantly slower response time in ADS compared to the control group. Comparing SDB children without ADHD and the control group without ADHD by excluding ADHD children in both groups, SDB children without ADHD did not show significantly higher scores in K-ARS but did show significantly slower ADS response time. CONCLUSION : Children with adenotonsillar hypertrophy are associated with increased SDB and ADHD symptoms. Therefore they may need intensive treatment such as surgical intervention.
Adenoidectomy ; Aged ; Child ; Enuresis ; Humans ; Hypertrophy ; Learning ; Linear Models ; Mood Disorders ; Parents ; Surveys and Questionnaires ; Reaction Time ; Sleep Apnea Syndromes ; Snoring ; Tonsillectomy ; Weights and Measures

OBJECTIVES : Adenotonsillar hypertrophy is one of the principal causes associated with snoring, sleep apnea, and restless sleep. These sleep-disordered breathing (SDB) is associated with hyperactivity, rebellious behavior, aggressiveness, enuresis, inattention, social withdrawal, and learning difficulties. The purpose of this study was to assess the impact of adenotonsillar hypertrophy on attention deficit hyperactivity symptoms and sleep-related symptoms in children by standard tests. METHODS : Children aged 5 through 15 years old, a total of 65 who were scheduled for Tonsillectomy and Adenoidectomy, were studied. The control group consisted of 30 healthy children of the same age. In both groups, attention-deficit hyperactivity dis-order (ADHD) was evaluated by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The degree of inattention, hyperactivity and sleep-related symptoms was evaluated by Korean ADHD Rating Scales (K-ARS), ADHD diagnostic system (ADS) and pediatric sleep questionnaire. The K-ARS and sleep questionnaire were completed by the parents of the children. RESULTS : Acording to K-SADS-PL, 23 subjects out of 65 subjects in the patient group and 2 subjects out of 30 subjects in the control group were diagnosed with ADHD. According to sleep questionnaires, the patient group reported significantly more problems than the control group. The patients had significantly higher cumulative questionnaire scores than the control group. In linear regression analysis, the cumulative score of sleep questionnaire was associated with inattention subscale scores, hyperactivity/impulsivity subscale scores and the total score of K-ARS, and also with the response time and the standard deviation of response time of ADS. In relation to ADHD, the patient group had significantly higher ADHD scores in K-ARS inattention subscale and significantly slower response time in ADS compared to the control group. Comparing SDB children without ADHD and the control group without ADHD by excluding ADHD children in both groups, SDB children without ADHD did not show significantly higher scores in K-ARS but did show significantly slower ADS response time. CONCLUSION : Children with adenotonsillar hypertrophy are associated with increased SDB and ADHD symptoms. Therefore they may need intensive treatment such as surgical intervention.
Adenoidectomy ; Aged ; Child ; Enuresis ; Humans ; Hypertrophy ; Learning ; Linear Models ; Mood Disorders ; Parents ; Surveys and Questionnaires ; Reaction Time ; Sleep Apnea Syndromes ; Snoring ; Tonsillectomy ; Weights and Measures

The prognosis of an early gastric cancer (EGC) is generally excellent, with a 5-year survival rate of 90% in most reports; however, there have been few reports of EGC with distant metastases. Recently we encountered a rare case of EGC with synchronous multiple bone metastases. A 43-year-old woman visited a local clinic due to back pain. Lumbar spine metastases were suspected by MRI. She was transferred to our hospital and underwent bone marrow biopsy which revealed an adenocarinoma. After endoscopic evaluation for primary cancer work-up, we found a suspicious EGC lesion. The results of endoscopic biopsy was signet ring cell carcinoma. Our pathologist additionally reviewed the bone marrow biopsy slides and found signet ring cells in it. PET CT showed disseminated multiple bone metastases but, there wasn't any other malignant lesion. Here we report a rare case of EGC with synchronous multiple bone metastases.
Adult ; Back Pain ; Biopsy ; Bone Marrow ; Carcinoma, Signet Ring Cell ; Female ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Prognosis ; Spine ; Stomach Neoplasms* ; Survival Rate

The prognosis of an early gastric cancer (EGC) is generally excellent, with a 5-year survival rate of 90% in most reports; however, there have been few reports of EGC with distant metastases. Recently we encountered a rare case of EGC with synchronous multiple bone metastases. A 43-year-old woman visited a local clinic due to back pain. Lumbar spine metastases were suspected by MRI. She was transferred to our hospital and underwent bone marrow biopsy which revealed an adenocarinoma. After endoscopic evaluation for primary cancer work-up, we found a suspicious EGC lesion. The results of endoscopic biopsy was signet ring cell carcinoma. Our pathologist additionally reviewed the bone marrow biopsy slides and found signet ring cells in it. PET CT showed disseminated multiple bone metastases but, there wasn't any other malignant lesion. Here we report a rare case of EGC with synchronous multiple bone metastases.
Adult ; Back Pain ; Biopsy ; Bone Marrow ; Carcinoma, Signet Ring Cell ; Female ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis* ; Prognosis ; Spine ; Stomach Neoplasms* ; Survival Rate