No abstract available.
Dyskeratosis Congenita*

No abstract available.
Leukemia*

Gram-negative toeweb infections have clinical manifest,ations of variable severity. In its mildest form, the affected tissue is damp, softened, boggy and white. But. more severe form may progress to marked denudation of second, third and fourth toewebs with a profuse serous or purulent discharge, and its treatment is difficult. We described a 39-year-old man who had ulcerated arid oozing patches on several toewebs. Pseudomonas aeruginosa was detected in bacterial cultures. We successfullg treated with split-thickness skin graft, and enoxacin on first, visit and enoxacin with gentamicin ointment, for 2 weeks on second visit.
Adult ; Enoxacin ; Gentamicins ; Humans ; Pseudomonas aeruginosa ; Skin ; Transplants ; Ulcer

Bile* ; Choledochal Cyst* ; Humans ; Infant* ; Peritonitis*

BACKGROUND: It is controversial whether the delay of surgery for acute appendicitis by physician results in higher morbidity. Our present study explores this problem of physician delay on the postoperative outcome of patients with acute appendicitis. MATERIAL AND METHODS: Among 432 patients admitted for the presumptive diagnosis of acute appendicitis between Jan., 1995 and Dec., 1997, 358 patients with pathologically proven acute appendicits were analyzed. Physician delay from the hospital admission to the surgery was evaluated in relation to the stage of the disease at operation and postoperative outcome. RESULTS: Postoperative complications occurred signifficantly higher in advanced appendicitis group, than in simple appendicitis group. Postoperative oral consumption started significantly later and hospital days are significantly prolonged in those group. Both patient and physician delays significantly affect the stage of the disease. The finding that physician delay correlated with the stage, however, was denied by multivariate analysis. CONCLUSION: On the contrary to the patient delay, physician delay does not affect the stage of the acute appendicitis nor lead to increased incidence of postoperative complication. Physician delay to clarify the diagnosis is a reasonable strategy and it does not affect the outcome adversely.
Appendicitis* ; Diagnosis ; Humans ; Incidence ; Multivariate Analysis ; Postoperative Complications

Despite major diagnostic advances, 10-30% of hepatic metastases of colorectal carcinoma remain undetected. In this study, CEA levels of peripheral (p-CEA), drainage venous blood(d-CEA) and gallbladder bile(b-CEA) in patients with colorectal cancer were determined to examine the significance of their CEA levels in predicting hepatic metastases. From January 1993 through May 1996, p-CEA, d-CEA and b-CEA were obtained in 50 colorectal carcinoma patients without gallbladder pathology. Synchronous hepatic metastases were found in 5 patients(Hm group) and 45 cases had no hepatic metastasis. Among the 27 cases who followed up over 2 years, metachronous hepatic metastases(Hr group) were found in 6 cases and remaining 21 cases had no metastases(Ho group). Elevation of p-CEA, d-CEA, and b-CEA was significantly correlated with lymph node metastases and hepatic metastasis. The b-CEA levels were significantly correlated with p-CEA(r=0.533926, p<0.0001) while d-CEA levels were not(r=0.276437, p=0.0520). Although all the levels of p-CEA, d-CEA, and b-CEA in Hr & Hm group were significantly higher than those in Ho group, d-CEA level was considered as most sensitive index in predicting hepatic metastases(mean 12.7 ng/ml in Ho, 88.6 in Hr, and 137.3 in Hm group. p<0.0001). The possible cut-off level of d-CEA was 40 ng/ml because all of the cases with d-CEA < 40 ng/ml had no hepatic metastasis nor hepatic recurrance, whereas 11 out of 12 patients with d-CEA > 40 ng/ml had hepatic metastases(5 synchronous, 6 metachronous). However it is impossible to establish the possible of b-CEA because of high false positive and negative rate in predicting metachronous hepatic metastases. In conclusion, it is suggested that d-CEA could be highly sensitive indicator for selecting high-risk patients of metachronous hepatic metastases of colorectal cancer.
Bile* ; Colorectal Neoplasms* ; Drainage* ; Gallbladder* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Pathology

PURPOSE: The prognosis of stage IV stomach cancer patients is very poor and the effectiveness of radical surgery including extended lymphadenectomy and combined resection in these patients is still controversial. The purposes of this retrospective study were to identify the prognostic factors and to evaluate the effectiveness of extended lymphadenectomy and combined resection in stage IV stomach cancer paients. MATERIALS AND METHODS: Of 585 patients who were operated for stomach cancer at the NMC from Jan. 1987 to Oct. 1993, 154 patients of stage IV stomach cancer (121 patients who had distant metastasis and 33 patients who had not) were identified. We analyzed data of these 154 patients to find the characteristic clinicopathological features, the prognostic factors and the proper extent of surgical treatment. RESULTS: Comparing with stage I, II and III groups, larger tumor size, higher proportions of Borrmann type IV and undifferentiated carcinoma and higher rates of lymph node metastasis and combined resection were noticed in stage IV stomach cancer group. In combined resection, pancreas tail was mainly resected due to tumor invasion but spleen was mainly resected for the completeness of lymph node dissection. In multivariate analyses, peritoneal metastasis and postoperative residual tumor were independent prognostic factors. The overall 5-year survival rate was 14.6%. Stage IV stomach cancer patients without distant metastasis had better 5-year survival rate than that of those who had distant metastasis (34.3% vs 7.9%, p=0.00001). CONCLUSIONS: Radical procedures including extended lymphadenectomy and combined resection of the invaded organs should be considered in the stage IV stomach cancer patients without distant metastasis.
Carcinoma ; Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm, Residual ; Pancreas ; Prognosis ; Retrospective Studies ; Spleen ; Stomach Neoplasms* ; Stomach* ; Survival Rate

No abstract available.
Leukemia*

No abstract available.
Anemia, Aplastic* ; Bone Marrow Transplantation* ; Bone Marrow* ; Immunomodulation*

One hundred thirty four early gastric cancer cases were analyzed to determine the clinicopathologic features influencing lymph node metastasis. Subtotal gastrectomy for 122 patients and total gastrectomy for 12 patients were carried on including lymph node dissection of node groups 1 and 2. The mean duration of the follow-up was 44.2 months. In this review, the only pathologic feature influencing lymph node metastasis was depth of invasion. The rate of lymph node metastasis was significantly higher in submucosal cancer(30.3%) than mucosal cancer(8.6%)(Chi-Square test, P=0.0009). The lymph node metastasis was the only independent prognostic factor of early gastric cancer(P=0.0006), and raise the question whether the present definition of early gastric cancer is still of value. Most important result of our study is that 20.9% of the early gastric cancer had pathologically proven lymph node metastasis, and have worse prognosis than the cases without metastasis. In stead of the currently used early gastric cancer, we propose superficial cancer for carcinoma confined to mucosa or submucosa on endoscopic finding, and to save the term of early gastric cancer for the cases in which the invasion limited to the mucosa or submucosa without lymph node metastasis.
Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Mucous Membrane ; Neoplasm Metastasis* ; Prognosis ; Stomach Neoplasms*