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*

There has been a considerable controversy on the prognosis of the mucinous gastric adenocarcinoma(MGC). In this study we analyzed the clinicopathologic differences between MGC and non-mucinous gastric carcinoma(NMGC). In addition, the relationship between mucin content and other clinicopathologic variables, including prognosis in MGC was examined. We reviewed 2118 patients with pathologically confirmed gastric cancer who had underwent gastrectomy at the department of surgery of Yonsei University College of Medicine, during the period between Jan. 1987 and Dec. 1993. Among them, 130 patients had gastric cancer with extracellular mucin(MGC) and 1988 patients had gastric carcinoma without extracellular mucin(NMGC). We studied the MGC patients into two groups according to mucin content: mucin content involving over 50% of the tumor(dominant type, n=94) and mucin content involving less than 50% of the tumor area(partial type, n=36). The results are as follows: The MGC was more common in male then NMGC. The size of tumor in MGC was larger than that of NMGC. The patients with MGC had higher incidence of Borrmann type IV, more frequent serosal invasion, lymph nodes metastasis and peritoneal metastasis than the patients with NMGC. The patients with MGC had more advanced stage at the time of diagnosis and worse overall 5-year survival rate than the patients with NMGC. But the 5-year survival rate according to the stage of MGC was similar to that of NMGC. There were no significant differences between the mucin content and other pathologic variables including prognosis. So we suggested that MGC has worse prognosis than NMGC and it is reasonable to consider the carcinoma with mucin content involving less than 50% of the tumor area as MGC.
Adenocarcinoma* ; Diagnosis ; Gastrectomy ; Humans ; Incidence ; Lymph Nodes ; Male ; Mucins* ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms ; Survival Rate

The prognoses for the gastric cancer patients treated with total gastrectomies are known to be unsatisfactory due to the low survival rates, the high frequency of postoperative mortality or morbidity, and long-term complications such as nutritional deficiency. The authors evaluated the 5-year survival rates and analyzed the prognostic factors in 557 patients with gastric cancer who underwent total gastrectomies during the period between Jan. 1987 and Dec. 1993. The overall 5-year survival rate was 49.7%, and the survival rates according to the stage were stage Ia, 92.0%; Ib, 85.5%; II 64.1%; IIIa 55.0%; IIIb 26.5%; and stage IV, 6.3%. Postoperative mortality rate was 1.1%. By using univariate analysis to evaluate the prognostic factors, factors such as age, depth of invasion, extent of lymph node metastasis (according to the Japanese rule), number of involved nodes, lymph node ratio, distant metastasis (peritoneal and/or hepatic), size of the tumor, gross type, histological type, the surgical curability and the TNM stage were found to be related with the survival of the patients. In a multivariate analysis using 11 variables, the TNM stage was the single most significant prognostic factor. Besides the TNM, depth of invasion (ratio of risk (R.R)=1.50), extent of lymph node metastasis (R.R=1.83), number of involved nodes (R.R=1.64), lymph node ratio (R.R=1.91), and peritoneal metastasis (R.R=3.11) were found to be independent prognostic factors influencing survival. It was thought that the radicality of surgery could be reflected in the number of removed nodes per specimen. In this study, the average number of removed nodes was 42.3 per case. Hence, it may be said that adequate lymphadenectomy was performed for almost all the grossly curable cancers. The 5-year survival rate in stage IV patients with tertiary node (N3) metastasis and no peritoneal or hepatic metastasis was 16.8%; in patients with peritoneal or hepatic metastasis, the survival rate was 0%. There was a significant survival difference between these two groups (p<0.05). This result suggests that the tertiary node metastasis is a potentially curable factor, and that it should be classified differently in the current TNM system. In conclusion, the overall survival rates in the patients treated with total gastrectomies were favorable compared with the results in other reports. Depth of invasion, extent of lymph node metastasis, number of involved nodes, lymph node ratio were important prognostic factors for survival after a total gastrectomy. The current TNM staging system appears to be a reasonable one, except that the probable curability of tertiary node metastasis may need to be taken into consideration.
Asian Continental Ancestry Group ; Gastrectomy* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Malnutrition ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms* ; Survival Rate