No abstract available.
Humans

No abstract available.
Gastrectomy* ; Stomach Neoplasms*

We present two cases of oral lichen planus associated with chronic liver diseases. One patient was a 56-year-old man that had advanced liver cirrhosis with hepatitis B viral infection, and the other, a daughter of patient 1, was identified as chronic active hepatitis with hepatitis B viral infection. Clinical and histopathological features of oral lesions were consistent with lichen planus in both cases.
Hepatitis B ; Hepatitis, Chronic ; Humans ; Lichen Planus ; Lichen Planus, Oral* ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Middle Aged ; Nuclear Family

No abstract available.
Breast* ; Hamartoma*

The claw-foot deformity is only a symptom of some primary lesion, not an entity in itself. The treatment of claw-foot usually depends on the type and severity of the deformity. In the past two years, authors have treated 7 cases of claw-foot, 3 of which were treated by Cole's anterior tarsal wedge osteotomy and 4 cases by Japas “V”-osteotomy of tarsus. In all 7 cases, Steindler's plantar fasciotomy for cavus deformity were combined and 1 case was combined with Achilles tendon lengthening. The followings were noted. 1. AlI patients were military personals and the ages were between 21 to 27 years old male. 2. Two patients were bilateral claw-foot deformity and both sides were operated. 3. The causes were secondary to poliomyelitis in one case and the others were idiopathic. 4. Postoperative complications were skin necrosis in one case and sensory disturbance on the dorsum of the first web space of the foot in 3 cases. 5. All patients can walk and run without pain after average 1 year follow-up period.
Achilles Tendon ; Ankle ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Foot Deformities ; Humans ; Male ; Military Personnel ; Necrosis ; Osteotomy ; Poliomyelitis ; Postoperative Complications ; Skin

PURPOSE: To evaluate the effects of trans-scleral diode laser cyclophotocoagulation (TSDLC) on best corrected visual acuity (BCVA) in patients with refractory glaucoma. METHODS: The medical records of 148 eyes of 148 patients with refractory glaucoma who were followed-up for over 6 months after TSDLC were analyzed retrospectively. Among them, 49 eyes of 49 subjects who had BCVA greater than no light perception (NLP) before TSDLC were classified as Group 1 and the other 99 eyes of 99 patients who had NLP vision were classified as Group 2. The outcomes of TSDLC including change in BCVA following surgery were analyzed for all patients and 49 subjects. RESULTS: The mean follow-up period in Group 1 was 19.1 +/- 13.5 months and 16.7 +/- 12.7 months in Group 2. The intraocular pressure (IOP) and the number of IOP lowering medications decreased in both groups (both p < 0.001). In all subjects, there was no significant difference between BCVA before surgery and at the last follow-up (2.4 +/- 0.9 log MAR and 2.5 +/- 0.8 log MAR, respectively, p = 0.612). However, in Group 1, BCVA was decreased from 1.4 +/- 1.0 to 1.9 +/- 1.1 log MAR after the TSDLC (p < 0.001). In those patients, visual loss > or = 0.2 log MAR was found in 31 eyes (63.3%) and light perception was lost in 15 eyes (30.6%). After treatment, corneal edema developed in 5 eyes (3.4%), phthisis bulbi and chronic hypotony occurred in 3 eyes each (2%) and iridocydlitis occurred in 2 eyes (1.4%). CONCLUSIONS: TSDLC in patients with refractory glaucoma showed an efficient reduction in IOP and the number of IOP-lowering medications. However, there was a significant loss in BCVA in many patients and therefore, careful monitoring regarding potential visual loss is necessary when considering TSDLC in glaucoma patients with useful vision.
Corneal Edema ; Follow-Up Studies ; Glaucoma* ; Humans ; Intraocular Pressure ; Lasers, Semiconductor* ; Medical Records ; Retrospective Studies ; Visual Acuity*

There has been considerable controversy over the prognosis of mucinous gastric enocarcinoma (MGC). In this study we analyzed the clinicopathologic fferences between MGC and non-mucinous gastric carcinoma (NMGC). In addition, e relationship between mucin content and other clinicopathologic variables, cluding prognosis in MGC, was also investigated. We reviewed 2118 patients th pathologically-confirmed gastric cancer who underwent gastrectomy at the partment of Surgery, Yonsei University College of Medicine, during the period tween Jan. 1987 and Dec. 1993. Among them, 130 patients had gastric carcinoma th extracellular mucin (MGC) and 1988 patients had gastric carcinoma without tracellular mucin (NMGC). We placed the MGC patients into two groups according mucin content: mucin content involving over 50% of the tumor (dominant type, = 94) and mucin content involving less than 50% of the tumor area (partial pe, n = 36). The results were as follows: MGC was more common in males than GC. The size of the tumor in MGC (mean 5.3 cm) was larger than that of NMGC ean 4.4 cm). The patients with MGC had a higher incidence of Borrmann type IV GC: 16.1%, NMGC: 9.9%), more frequent serosal invasion (MGC: 75.4%, NMGC: .6%), lymph-node metastasis (MGC: 75.4%, NMGC: 50.7%), and peritoneal tastasis (MGC: 10.0%, NMGC: 3.5%) than patients with NMGC. The patients with C were more advanced in stage at the time of diagnosis and had a worse overall -year survival rate (44.9%) than patients with NMGC (54.7%). However, the -year survival rate according to the stage of MGC was similar to that of NMGC. ere were no significant differences between the mucin content and other thologic variables, including prognosis, i.e. similar biologic behavior tween dominant type MGC and partial type MGC. In conclusion, we suggest that C was more frequently diagnosed in advanced stage than NMGC with a poorer ognosis and that it is reasonable to consider the carcinoma with mucin content volving more than 30% of the tumor area as MGC.
Adenocarcinoma/pathology ; Adenocarcinoma/metabolism ; Adenocarcinoma, Mucinous/pathology* ; Adenocarcinoma, Mucinous/metabolism* ; Adult ; Aged ; Aged, 80 and over ; Female ; Human ; Male ; Middle Age ; Mucins/metabolism ; Neoplasm Staging ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/metabolism*

PURPOSE: Until several years ago, gastric or hepatic resection was seldom indicated for metastatic gastric cancer because of the expected dismal prognosis. Recently, some studies have reported benefits from gastric or hepatic resection for metastatic gastric cancer. We performed this retrospective study to see the prognosis after aggressive surgery in gastric cancer patients with hepatic metastasis. MATERIALS AND METHODS: A total of 112 gastric cancer patients were confirmed to have liver metastasis at the time of initial surgery or preoperative evaluation during the 8-year period from January, 1987 to December, 1994 at the Department of Surgery, Yonsei University, College of Medicine. Thirty eight cases (33.9%) underwent gastrectomy (total gastrectomy: 15, subtotal gastrectomy: 23). Of these 38 cases, 12 underwent a combined resection of metastatic hepatic tumors (segmentectomy: 7, wedge resection: 3, lobectomy: 1 and enucleation: 1). RESULTS: The locations of primary lesion were most common in the lower 1/3 of the stomach in all of the nonresected, the gastrectomy only, and the gastrectomy & hepatectomy group. Most of the cancers belonged to Borrmann type III and IV. Histologically, dedifferentiated cancer (poorly differentiated cancer, signet ring cell cancer, mucinous cancer) was more frequent in the nonresected group (67.4%) while differentiated cancer (papillary cancer, well differentiated cancer, moderately differentiated cancer) was more frequent in the resected group (60.9%). The number of metastatic hepatic nodules were less than two in the resected group and the location of metastatic lesions tended to be limited to one lobe. Concerning the prognosis, the mean survival of the resected group was better than the nonresected group (nonresected group: 8.4 months, gastrectomy only group: 18.4 months, gastrectomy & hepatectomy group: 35.5 months). The mean score of QOL (quality of life) according to Spitzer index was better in the resected group (nonresected group: 5.1, gastrectomy only group: 6.0, gastrectomy & hepatectomy group: 7.5). CONCLUSION: Resection of both the primary gastric lesion and the metastatic hepatic lesion should be considered in selected cases to improve the survival and the quality of life in patients with hepatic metastasis.
Gastrectomy ; Hepatectomy ; Humans ; Liver* ; Mucins ; Neoplasm Metastasis* ; Prognosis* ; Quality of Life ; Retrospective Studies ; Stomach ; Stomach Neoplasms*

A retrospective study of 2,603 patients with gastric cancer who underwent a gastric resection at Yonsei University Hospital from 1987 to 1994 was performed to evaluate the clinicopathological characteristics and survival rates of patients with gastric cancer. There were 1721 males and 882 females (ratio=2:1) with a mean age of 54 years (range=22~85 years). All patients underwent gastric resection with curative intent, but 199 patients (7.6%) had a palliative resection. The types of operations were a subtotal gastrectomy in 1,917 patients (73.6%) and a total gastrectomy in 686 patients (26.4%). A D2 or a more extended lymph-node dissection was performed in 2530 patients (97.2%), and only 73 patients (2.8%) had less extensive surgery. The postoperative mortality was 0.9%. The mean diameter of a tumor was 5.6 cm. The most common location of a tumor was the lower third of the stomach (49.4%). Borrmann type III (64.7%) was the most common gross type. The major histologic type was a tubular adenocarcinoma (76.3%). The overall 5-year survival rate was 66.5%. The 5-year survival rates according to the stage were 94.3% in IA, 90.5% in IB, 76.6% in II, 60.1% in IIIA, 38.7% in IIIB, and 12.9% in IV. In the univariate analysis, poor survival was closely related to increasing age, tumor location in the upper one third, larger tumor size, Borrmann type IV tumors, increasing pT and pN classifications, an advanced tumor stage, and perforance of a total gastrectomy. The multivariate analysis revealed that distant metastasis, lymph-node metastasis, depth of invasion, gross type, age, and type of resection were significant prognostic factors. In conclusion, the prognosis for gastric cancer after a gastrectomy has remarkably improved, and the most significant prognostic factors were distant metastasis, lymph node metastasis, and depth of invasion. Therefore, early diagnosis of gastric cancer and aggressive multimodal therapy, especially in patients with stage IIIB and IV tumors might improve the quality of life and the survival of the patients with gastric cancer.
Adenocarcinoma ; Classification ; Early Diagnosis ; Female ; Gastrectomy* ; Humans ; Lymph Nodes ; Male ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Quality of Life ; Retrospective Studies ; Stomach ; Stomach Neoplasms* ; Survival Rate*

Combined resection of the spleen during total gastrectomy for gastric cancer is usually performed to remove the lymph nodes adequately and thereby achieving surgical radicality. However there is still controversy whether a total gastrectomy combined with a splenectomy can improve the survival rate. The authors retrospectively analyzed 557 gastric cancer patients, who underwent total gastrectomy at the Department of Surgery of Yonsei University during the 7-year period between 1987 and 1993, in order to investigate the influence of combined resection of the spleen upon the patients' survival. The patients were followed until March 1996, and the rate of follow up was 90.6%. The number of cases in which the spleen was saved was 101(the spleen conservation group, SC) and the number of cases in which the spleen was resected was 431(the spleen resection group, SR). Twenty-five cases were excluded due to incomplete data. Among the 431 cases for whom splenectomy was done, 343 were cases in which spleen was the only organ removed other than the stomach (SOR). For the other 88 cases, at least 1 more organs were resected along with the stomach and the spleen(Sp combined). There were no significant differences in the clinical characteristics such as age, sex ratio, tumor size, depth of invasion, nodal stage, TNM stage and histological type between SC and SOR group. In terms of the nodes removed during operation, there was significant difference between the SC and the SOR groups. Also, the Sp combined group showed significant differences in terms of tumor size, depth, nodal stage, TNM stage, and removed nodes. The overall 5-yr survival rate for the spleen conservation group(SC, N=101) was 61.2% and the survival rates according to TNM stage were 94.0% for stage I, 94.1% for stage II, 30.0% for III, and 0.0% for stage IV. The overall 5-yr survival rate for the 343 patients with splenectomy(SOR) was 51.9%, and the survival rates according to TNM stages were 88.7% for stage I, 57.0% for II, 44.0% for III, and 10.8% for stage IV. The overall 5-yr survival rate for the 431 patients with splenectomies or with splenectomies and multiple organ resection(SR) was 48.2%, and the survival rates according to the stages were 88.2% for stage I, 60.2% for II, 41.5% for III, and 6.8% for stage IV. The overall 5-yr survival rate was higher in SC group than in the SOR or the SR groups, but there was no statistical significance to this difference (p>0.05). In a compared according to the TNM stage, the SC group showed better survival rates in the relatively early stages (I, II) than the SOR or the SR groups did; in advanced stages (III, IV), the SOR and the SR groups showed better survival rates than the SC group. However, there was no statistically significant differences in survival among the three groups. These results suggest that during a total gastrectomy, it may be better to save the spleen in early stages of gastric cancer and that it may be better to resect the spleen for adquate lymphadenectomy in grossly advanced stages. To identify statistical difference in survival, it might be necessary to perform a randomized prospective study.
Follow-Up Studies ; Gastrectomy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Retrospective Studies ; Sex Ratio ; Spleen* ; Splenectomy ; Stomach ; Stomach Neoplasms* ; Survival Rate