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

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

PURPOSE: In locally advanced head and neck cancer, radiation therapy is currently unsatisfactory because the end result is often limited regional disease control and survival. A clinical study was carried out to compare the effectiveness between the radiation therapy and the combined chemotherapy and radiation therapy. MATERIALS AND METHOD: Thirty-six patients with previously untreated, locally advanced squamous cell carcinoma of the head and neck were treated with radiotherapy alone and combined chemo-radiotherapy. Induction chemotherapy was administered 2~3 cycles, consisting of intravenous cisplatin (100 mg/m2 on day 1) and 5-fluorouracil (1000 mg/m2/day for 5 days as a continuous infusion) every 4 weeks followed by 7~8 weeks of radiation therapy for a total dose of 60~75 Gy. RESULTS: 1) Among 36 locally advanced head and neck cancer, 17 patients received radiation therapy alone and 19 patients received combined chemo-radiotherapy, respectively. 2) Response rate was 47% (complete response 29%, and partial response 18%) in radiation therapy group and 79% (complete response 37%, and partial response 42%) in combined chemo-radiotherapy group (p<0.05). 3) In median survival, radiation therapy group was 13 months and combined chemo- radiotherapy group was 15 months. Both groups were not significantly different (p>0.05). 4) Treatment related mortality was not noted, but the toxic effects were seen on the half cases of the both groups. Grade II toxicities were similar between the two arms. CONCLUSION: Combined chemotherapy and radiation therapy was more effective in local control but not superior in survival than radiation therapy alone. Continuous evaluation and identification of proper sequence for the therapeutic modality is supposed to prolong the survival of patients.
Arm ; Carcinoma, Squamous Cell ; Cisplatin ; Drug Therapy* ; Fluorouracil ; Head and Neck Neoplasms* ; Head* ; Humans ; Induction Chemotherapy ; Mortality ; Neck ; Radiotherapy

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