We report metastatic omental hepatocellular carcinoma in two patients with post-lobectomy hepatocellular carcinoma who have had previous abdominal surgery or the rupture of hepatocellular carcinoma. Ometal metastatic masses were similar to primary masses of the liver in pathologic findings as well as in radiologic findings.
Carcinoma, Hepatocellular* ; Humans ; Liver ; Rupture

No abstract available.
Carcinoma, Bronchogenic*

The goal of total knee replacement is to relieve pain, to stabilize joint movement and to correct deformity. It is indicated for patients with rheumatoid arthritis, osteoarthritis and severe post-traumatic arthritis. The author analyzed 71 patients(106 cases), who received the PFC type of total knee replacement from August 1992 and the results were as follows; 1. Among the 71 patients, male was 8 patients and female was 63 patients whose average age was 56 years and average follow up period was 24 months, ranged from 8 months to 3 years 8 months. 2. Rheumatoid arthritis was the most common cause with 31 patients(56 cases) followed by osteoarthritis with 39 patients(49 cases). There was also one patient(1 case) that showed bony union of the knee due to old tuberculosis. The average duration of the illness was 12 years and the average weight of the patients was 57.7kg. 3. Flexion contracture decreased from an average of 21 degrees to 5 degrees after the operation. The range of motion increased from an average of 92 degrees before the operation to 117 degrees afterwards in cases of rheumatoid arthritis and decreased slightly from 108 degrees to 106 degrees in cases of osteoarthritis. 4. The tibiofemoral angle was corrected from an average 1.5 degrees varus before the operation to an average 6.7 degrees valgus after operation. Eighty seven percent of patients with rheumatoid arthritis showed valgus deformity and seventy eight percent of degenerative osteoarthritis patients showed varus deformity preoperatively. 5. Radiographically, the joint line position shifted an average 2.3mm in rheumatoid arthritis and an average 0.3mm in osteoarthritis. The component position, the femoral flexion was an average 89.6 degrees in the anteroposterior view, an average 87 degrees in the lateral view. 6. The thickness of the patella measured in the operating room of 61 cases was an average 21mm and after resection of patella, the remaining bone measured an average of 13.6mm. 7. To achieve soft tissue balance, 29 patients(33 cases) underwent medial stripping and 23 patients(30 cases) had patella lateral release. 8. The Insall Knee Rating Score was used to evaluate the results. The results were 69 cases excellent, 33 cases good, 3 fair and 1 poor. Ninety two percent of the patients had good or excellent results in average 24 months follow-up. 9. The complications consisted of one case of delayed deep infection, one case of patellar subluxation and one case of supracondylar fracture of the femur.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Contracture ; Female ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Operating Rooms ; Osteoarthritis ; Patella ; Range of Motion, Articular ; Tuberculosis

The rectal prolapse syndome is a disease entity includes rectocele and rectal prolapse, presenting prolapse(procidentia) of rectum. In rectocele, rectum is prolapsed anteriorly into the vagina, whereas in procidentia, inferiorly out of the anus. This study was aimed at analyzing pathogenesis and adequacy of surgical treatment in rectocele and rectal prolapse. Twenty-one patients with rectocele and 18 patients with rectal prolapse were assessed pre- and post-operatively in respect to symptoms and signs, pathogenesis, defecography, and manometry. In analysis of symptoms and sings, constipation was the commonest in both diseases(86% of rectocele and 67% of rectal prolapse) and incontinence was not infrequently found in both diseases as well(14% of rectocele and 33% of rectal prolapse). In analysis of the underlying causes, two patients with rectal prolapse had prolapse from childhood. Defecography showed anorectal angle of rectal prolapse in rest and push period. They were significantly wider than those of rectocele(p<0.05). The perineal descent of rectal prolapse was longer than that of rectocele. In analysis of the associated factors, average number of delivery was more than three times in both diseases(3.5 of rectocele and 5.1 of rectal prolapse). We could easily find previous operation history in both diseases. Among them, hysterectomy was the most frequent, especially in patients with rectocele. The hemorrhoids was associated more common in rectocele than in rectal prolapse(p<0.05). Preoperative maximal resting pressure of rectal prolapse was more significantly decreased than that of rectocele(p<0.05). The sensation of fullness was significantly decreased in patients with rectal prolapse postoperatively(p<0.05). Patients with rectocele underwent levator plication by transrectal or vaginal approach. Patients with rectal prolapse underwent posterior rectopexy in 11 patients, resection and rectopexy in 3 patients, Delorme's operation and Thiersch operation in 2 patients each. Constipation was significantly improved in patients with rectocele postoperatively(p<0.05). Incontinence was markedly improved in patients with rectal prolapse postoperatively(p<0.05). At the interview about subjective improvement of symptom, 95% of patients with rectocele and 89% of patients with rectal prolapse were satisfied with surgery. In conclusion, rectocele and rectal prolapse can be categorized as rectal prolapse syndrome because both diseases have anatomical derangements caused by similar pathogenesis such as altered bowel habits, anatomical factor, delivery, past history of hysterectomy, and hemorrhoids. Levator plication and posterior rectopexy seem to be useful surgical methods of anatomical repair for the respective disease.
Anal Canal ; Constipation ; Defecography ; Hemorrhoids ; Humans ; Hysterectomy ; Manometry ; Prolapse ; Rectal Prolapse* ; Rectocele ; Rectum ; Sensation ; Vagina

No abstract available.
Humans ; Prognosis* ; Respiratory Insufficiency*

Most renal carcinomas are thought to originate from the epithelial cells of proximal convoluted tubules in the renal cortex. Collecting duct carcinoma is a recently recognized histological variety of renal cell carcinoma considered to arise from the epithelium of the collecting ducts. It is important to distinguish the collecting duct carcinoma from ordinary renal cell carcinoma, because which has an aggressive clinical course with early metastasis and death. But in patients, the natural course of the disease and its response to treatment have not been clearly established. Herein we report a case of collecting duct carcinoma of kidney in 38-year-old woman who had generalized edema and left flank dull pain. The preoperative diagnosis was left renal cell carcinoma on physical examination and radiologic finding, and left radical nephrectomy was done.
Adult ; Carcinoma, Renal Cell* ; Diagnosis ; Edema ; Epithelial Cells ; Epithelium ; Female ; Humans ; Kidney* ; Neoplasm Metastasis ; Nephrectomy ; Physical Examination

No abstract available.
Myasthenia Gravis* ; Pregnancy*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

PURPOSE: To elucidate the pitfalls of Tc-99m RBC liver SPECT in the diagnosis of hepatic hemangioma, and to compare this modality with two-phase dynmic CT. MATERIALS AND METHODS: Forty patients with 48 liver masses, suspected on ultrasonography to be hemangiomas, underwent two-phase dynamic CT scanning and SPECT within a two week period. All masses were diagnosed through pathologic and follow up radiologic studies. The final diagnoses were hemangioma (n=42), metastasis (n=2), abscess (n=2), hepatocellular carcinoma (n=1), and cholangiocarcinoma (n=1). Sensitivities and specificities of CT and Spect for the diagnosis of hemangioma and the relationship between false positives or false negatives seen on SPECT and the Pattern of contrast enhancement seen on CT were investigated. RESULTS: The sensitivities of CT and SPECT for the diagnosis of hemangioma were 95.2 (40/42) and 76.2% (32/42), respectively. The false-negative rate of SPECT was significantly higher in the early enhancing (54.5%, 6/11) than in the late enhancing type (13.8%, 4/29) and in the 'less than 1cm' group, false-negatives (70%, 7/10) were more common than in the 'more than 1cm' group (9.4%, 3/32). for the two lesions with false-positive findings on SPECT, the final diagnosis was metastasis, and two false-negative lesion, seen on CT, were misread as metastases. Four other lesions were negative in both studies. CONCLUSION: For the detection of hepatic hemangioma, two-phase dynamic CT is a better modality than SPECT. False positives on SPECT occurred in metastasis, and false negatives are more common in the small lesion and early enhancing group than in the late enhancing group. Between the two groups, there is a difference in hemodynamics, and considerable further pathological investigation is needed.
Abscess ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Diagnosis* ; Follow-Up Studies ; Hemangioma* ; Hemodynamics ; Humans ; Liver ; Neoplasm Metastasis ; Tomography, Emission-Computed, Single-Photon* ; Tomography, X-Ray Computed ; Ultrasonography

No Abstract Available.
Cytomegalovirus* ; Enzyme-Linked Immunosorbent Assay* ; Humans*