PURPOSE: A laterally spreading tumor (LST) has its own characteristic features and growth pattern. Information about LST is scanty in Korea, therefore this study was designed in order to contribute to the literature. METHODS: In this study, 43 patients with LSTs were included. The diagnoses were made by colonoscopy in all cases. Treatment options included endoscopic resection, transanal excision, and surgical resection. In reviewing and analyzing the cases, we made a special emphasis on size, classification, histology, and treatment. RESULTS: The most frequent location was the rectum, followed by the sigmoid colon and the ascending colon in that order. Lesions smaller than 20 mm accounted for 69.8%. Granular homogeneous LSTs, 41.9%. Lesions larger than 20 mm, except granular homogeneous LSTs, showed an abrupt increase in malignancy rate. Tubular adenomas accounted for 65.1%. The overall malignancy rate was 20.9%, and the submucosal cancer rate, 9.3%. There were no malignancies in the granular homogeneous LSTs. The malignancy rate for the mixed-nodule type lesions was 33.3% (4/12), and the nongranular LSTs, 38.5% (5/13). Polypectomy was done in 37.2% of the lesions, endoscopic mucosal resection (EMR) in 16.3%, and endoscopic piecemeal mucosal resection (EPMR) in 16.3%. The overall endoscopic resection rate was 83.7% (36/43). EMR was applicable to lesions smaller than 20 mm, and EPMR to those larger than 20 mm. Transanal resection was done in 2 cases with lesions. Five cases were resected surgically. Four of them were submucosal invasive lesions, and one, a mucosal lesion which was wide and had initially been thought to be a submucosal cancer. There were two recurrences during the average 15-month follow-up period. The follow-up rate was 81.4% (35/43). Of these 2 recurring cases, one patient was treated endoscopically and the other, transanally. CONCLUSIONS: LSTs show different behavior depending on the endoscopic classification. Granular homogeneous LSTs are seldom larger than 30 mm and are good candidates for endoscopic treatment. The mixed-nodule type and the nongranular type show a marked predisposition to malignancy when they are over 20 mm, and nongranular-type LSTs have a higher rate of submucosal invasive cancers. Thus, in the cases of the mixed-nodule and nongranular types, careful consideration should be given for deciding between endoscopic treatment and surgical resection. Complete resection should be assured to prevent recurrence, and follow-up surveillance is required in all lesions for more than 3 to 5 years.
Adenoma ; Classification ; Colon, Ascending ; Colon, Sigmoid ; Colonoscopy ; Diagnosis ; Follow-Up Studies ; Humans ; Korea ; Rectum ; Recurrence

No abstract available.
Abscess* ; Eosinophils* ; Humans ; Liver Transplantation* ; Liver* ; Living Donors* ; Transplants*

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

No abstract available.
Ifosfamide*

The mesenchymal chondrosarcoma of the orbit is so rare that only a few cases have been reported in Korea and world-wide. We experienced that a patient whose complaints were proptosis and diplopia caused by orbital tumor. After tumor removal, it was histologically diagnosed as mesenchymal chondrosarcoma. So we report a case of mesenchymal chonrosarcoma of the orbit with a review of the literature.
Chondrosarcoma, Mesenchymal* ; Diplopia ; Exophthalmos ; Humans ; Korea ; Orbit*

Primitive neuroectodermal tumors(PNETs) may be a term established recently for a tumor group(?) which is composed of prominent undifferentiated cells with variable foci of differentiation along glial and neuronal lines. The authors experienced a case of 'primitive glioma' regarded as a subclass of PNETs, in a 14 year old boy who had suffered from headache and vomiting for about 40 days prior to admission. Brain CT and angiographic studies reveal a huge hypovascular mass lesion with multiple cysts in the left frontal lobe. The patient was satisfactorily treated by total tumor excision and following irradiation, and is now in follow up. We present the case with review of the literatures.
Adolescent ; Brain ; Follow-Up Studies ; Frontal Lobe ; Headache ; Humans ; Male ; Neural Plate ; Neuroectodermal Tumors, Primitive* ; Neurons ; Vomiting

Intracranial calcification is relatively common, but calcification of chronic subdural hematoma is rare condition. Nevertheless, already in 1884 Von Rokitansky had described a calcified chronic subdural hematoma found at autopsy. Subsequently Lewis(1889), Elsner(1896), and O'sullivan(1925) mentioned calcification of intracranial hematoma. In 1930, Goldham reported the first case treated by operation. A 15-year-old Korean male was admitted to this hospital because of a episode of generalized epileptic seizure, one day before admission. Past history was unknown about head injury and his past birth condition. Patient has complained weakness of right upper and lower extremely since his infant. Neurological examination revealed the left hemiparesis, but others were normal. Skull X-ray films showed dense conglomerated calcific density with surrounding rim like lucency in left fronto-parietal region. Left carotid angiogram revealed no abnormalities except hypoplasia of left hemisphere. Brain computed tomogram demonstrated hyperdense subdural mass surrounding decreased parenchymal density in left fronto-parietal region. A craniectomy was performed for removal of the calcified mass. A oval concaved bony hard mass was found in subdural space. The calcified bony hard mass was adherent with the surface of cortex by loose sonnective tissue. We removed the bony hard mass completely. The postoperative course was very satisfactory and seizure has not been appeared after discharge. Microscopic findings demonstrated ossification and fibrosis, consisting with old hematoma which showed up a calcification of chronic subdural hematoma.
Adolescent ; Autopsy ; Brain ; Child* ; Craniocerebral Trauma ; Epilepsy ; Fibrosis ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Infant ; Male ; Neurologic Examination ; Paresis ; Parturition ; Seizures ; Skull ; Subdural Space ; X-Ray Film

The meningioma constitutes 12 to 16 percent of all intracranial tumors. Generally, meningiomas arise from intracranial arachnoid villi and located intracranially. Extension of an intracranial meningioma onto the frontal and ethmoidal sinus occurs occassionally, but primary meningiomas of the frontal and ethmoidal sinus are extremely rare. The authors experienced a case of cystic, meningotheliomatous meningioma containing lamellated calcification involving of the lest frontal and ethmoidal sinus, which presented with protrusion of frontal bone and exophthalmos. In addition to our case, other types of extracranial meningioma are discussed with review of literature.
Arachnoid ; Exophthalmos ; Frontal Bone ; Meningioma*

PURPOSE: The purpose of this study is to investigate the effect of the titanium implant soaked in saline after RBM and acid etched surface treatment on the initial osseointegration by comparing the removal torque and the surface analysis compared to the titanium implant with only RBM and acid etched surface treatment. MATERIALS AND METHODS: The control group was RBM and acid etched surface treated implants (RBM + HCl), and the test group was implants soaked in saline for 2 weeks after RBM and acid etched surface treatment (RBM + HCl + Sal). The control and test group implants were placed in the left and right tibiae of 10 rabbits, respectively, and at the same time, the insertion torque (ITQ) was measured. After 10 days, the removal torque (RTQ) was measured by exposing the implant site. FE-SEM, EDS, Surface roughness and Raman spectroscopy were performed for the surface analysis of the new implant specimens used in the experiments. RESULTS: There was significant difference in insertion torque and removal torque between control group and experimental group (P = 0.014 < 0.05). Surface roughness of experimental group is higher than control group. CONCLUSION: Saline soaking after RBM and acid etched surface treatment of titanium implants were positively affect the initial osseointegration as compared to titanium implants with only RBM and acid etched surface treatment.
Hydroxyapatites ; Immersion ; Osseointegration ; Rabbits ; Sodium Chloride ; Spectrum Analysis, Raman ; Tibia ; Titanium ; Torque

Injury to the bilateral internal branch of superior laryngeal nerve (ibSLN) brings on an impairment of the laryngeal cough reflex that could potentially result in aspiration pneumonia and other respiratory illnesses. We describe a patient with traumatic cervical injury who underwent bilateral ibSLN palsy after anterior cervical discectomy with fusion (ACDF). An 75-year-old man visited with cervical spine fracture and he underwent ACDF through a right side approach. During the post-operative days, he complained of high pitched tone defect, and occasional coughing during meals. With a suspicion of SLN injury and for the work up for the cause of aspiration, we performed several studies. According to the study results, he was diagnosed as right SLN and left ibSLN palsy. We managed him for protecting from silent aspiration. Swallowing study was repeated and no evidence of aspiration was found. The patient was discharged with incomplete recovery of a high pitched tone and improved state of neurologic status. The SLN is an important structure; therefore, spine surgeons need to be concerned and be cautious about SLN injury during high cervical neck dissection, especially around the level of C3-C4 and a suspicious condition of a contralateral nerve injury.
Aged ; Cough ; Deglutition ; Diskectomy ; Humans ; Laryngeal Nerves ; Meals ; Neck Dissection ; Paralysis ; Pneumonia, Aspiration ; Reflex ; Spine