Objective The aim of this study was to evaluate the clinicopathologic findings of eight patients with primary cancer of fallopian tube diagnosed and treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center for nine years. Methods Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and survival of patients were reviewed retrospectively. Results The patients with primary cancer of fallopian tube constituted 0.4% of all gynecologic malignancies encountered during this period. The age of patients ranged 42 to 70 years(mean+/- S.D.; 53.9+/-9.9) and half of patients were postmenopausal and two patients were nulliparous. Patients were treated by simple or radical hysterectomy and bilateral salpingoophorectomy with or without omentectomy and five patients received postoperative chemotherapy. The FIGO surgical stages of the patients were I(4 cases), II(2 cases), III(1 case) and IV(1 case). There were 3 cases of adenocarcinoma, 3 cases of malignant mixed Mullerian tumor, 1 case of undifferentiated carcinoma and 1 case of serous cystic tumor of low malignancy potential. Serum CA 125 values were followed during treatment and decreased during clinical remission and increased at the time of tumor progression. The mean follow-up duration was 24.3(+28.3) months and 7 patients were alive free of disease and one patients with stage Ic died of the disease. Conclusion Primary fallopian tube cancer is an extremely rare malignancy of the female genitalia and preoperative diagnosis of this disease is difficult. Cytoreductive surgery and postoperative combination chemotherapy seem to be effective treatment and CA 125 value could reflect the disease status during the treatment and follow-up of patients.
Adenocarcinoma ; Carcinoma ; Chungcheongnam-do ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Genitalia, Female ; Gynecology ; Humans ; Hysterectomy ; Obstetrics ; Retrospective Studies ; Ulsan

PURPOSE: Routine pancreatico-splenectomy with total gastrectomy should no longer be considered as the standard surgical procedure for gastric cancer because of the lack of proven surgical benefit for survival. The aim of this study is to evaluate the clinicopathologic factors and the survival of patients with locally advanced gastric cancer and they had undergone combined pancreatico-splenectomy with a curative intent. Material and Methods: We retrospectively reviewed a total of 118 patients who had undergone total gastrectomy with distal pancreatico-splenectomy from 1990 to 2001. The patients were divided into 2 groups: 90 patients who were free from cancer invasion (group I), and 28 patients with histologically proven cancer invasion into the pancreas (group II). The various clinicopathologic factors that were presumed to influence survival and the survival rates were analyzed. RESULTS: The rate of pathological pancreatic invasion was 23.7%. The tumor stage, depth of invasion, pancreas invasion, lymph node metastasis, lymph node ratio, curability and the hepatic and peritoneal metastasis were statistically significance on univariate analysis. Among these factors, the tumor stage, lymph node ratio and curability were found to be independent prognostic factor on multivariate analysis. The 5-years survival rates were 36.2% for group I and 13.9% for group II. The morbidity rate was 22.1%, and this included pancreatic fistula (5.1%), intra-abdominal abscess (4.2%) and bleeding (4.2%). The overall mortality rate was 6.8%. CONCLUSION: Combined distal pancreatico-splenectomy with total gastrectomy with a curative intent was selectively indicated for those patients with visible tumor invasion to the pancreas, a difficult complete lymph node dissection around the distal pancreas and spleen, and no evidence of liver metastasis or peritoneal dissemination.
Abdominal Abscess ; Gastrectomy* ; Hemorrhage ; Humans ; Liver ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Multivariate Analysis ; Neoplasm Metastasis ; Pancreas ; Pancreatic Fistula ; Retrospective Studies ; Spleen ; Stomach Neoplasms* ; Survival Rate

Cartilage-forming tumors are benign cartilaginous tumors that rarely affect the spinal canal. They account for 2% of all spinal tumors and 2.6% of all benign bone tumors, and involvement of the vertebral column is found in 3-5% of the cases. Pathologically, they may be classified as chondroma, osteochondroma, chondroblastoma and chondromyxoid fibroma. This oncotype may remain asymptomatic or may present as a hard paravertebral swelling, or -more rarely- be accompanied by a slowly developing neurologic syndrome. We report the case of a 38 -year- old man in whom pain in the left buttock and left leg developed. Surgery involved a left partial hemilaminectomy and the mass was totally excised.
Buttocks ; Chondroblastoma ; Chondroma ; Fibroma ; Leg ; Osteochondroma* ; Spinal Canal ; Spine*

We report a case of accidental epidural ephedrine injection. A 29-year-old male with left femoral artery occlusion was scheduled for thromboembolectomy. The operation was performed under epidural anesthesia. During the operation, ephedrine (30 mg/6 ml) was accidentally injected through epidural catheter instead of ropivacaine (45 mg/6 ml). Following the incident, we injected normal saline (10 ml) in the epidural space to dilute the solution. The patient had no complaint but blood pressure rose to 165/115 mmHg transiently. We observed the patient closely in recovery room and no further complication was found. In previous reports, various attempts have been tried to manage such incidents, but no definitive treatment for accidental injection is known. We present this case to remind the importance of confirming the drug everytime before injection.
Adult ; Amides ; Anesthesia, Epidural ; Blood Pressure ; Catheters ; Ephedrine ; Epidural Space ; Femoral Artery ; Humans ; Injections, Epidural ; Male ; Recovery Room

BACKGROUND: Formaldehyde is used to preserve cadaver in medical schools, and students are exposed to formaldehyde during cadaver dissection classes. When humans are exposed to formaldehyde, it induces mucosal inflammation, skin inflammation, and declining of neurobehavioral function including attention and memory executive functions. The purpose of this study is to identify the effects of formaldehyde exposure on student's neurobehavioral performance during cadaver dissection classes. METHODS: The level of formaldehyde was measured in a cadaver dissection class. A total of 16 students were randomly divided into two groups. One group wore respiratory protection masks, while the other group did not. Among many subtests in Korean Computerized Neurobehavioral test, backward digit span was tested on all subjects before and after the class. RESULTS: The length of memorized digit span between the two groups was not significant; however there was a greater decrease in neurobehavioral function after formaldehyde exposure in the non-mask group than the mask group. CONCLUSION: Formaldehyde exposure during cadaver dissection may likely decrease neurobehavioral performance of students. Therefore, proper ventilation system and respiratory protective equipment are necessary to protect medical school students from adverse effects of formaldehyde exposure.
Cadaver* ; Executive Function ; Formaldehyde* ; Humans ; Inflammation ; Masks ; Memory ; Schools, Medical ; Skin ; Ventilation

No abstract available.
Occupational Health*

We reviewed 49 cases of moderate or severe pericardial effusion on which we performed pericardiocentesis and percutaneous pericardial biopsy from Jan. 1987 to Sep. 1989. Of these, 11 cases were performed percutaneous pericardial biopsy in order to diagnose confirmative. We studied clinical manifestation including physical examination, ECG, and radiology, etiology and complication of pericardiocentesis and percutaneous pericardial biopsy. The results are as belows : 1) The physical examination of pericardial effusion were neck vein engorgement(73.5%), priction rub(25.5%), and pulsus paradoxus(4%). The ECG findings were low voltage(77.6%) and electrical alternans(16.5%), and most common x-ray finding was cardiomegaly (81.6%). 2) Underlying diseases were as follows : neoplastic disease(40.8%), tuberculosis(18.4%) systemic lupus erythematosus(10.2%), hemopericardium(8.2%), chronic renal failure(6.1%), congestive heart failure(4.1%), idiopathic pericarditis(4.1%), GVHD(2.0%), pyopericardium(2.0%), rheumatic carditis(2.0%), and postpericardiotomy syndrome(2.0%), in order. 3) Special etiologic diagnosis of neoplasm were lung cancer(50%), adenocarcinoma of unknown origin(20%), Malignant lymphoma(15%), stomach cancer(5%), hepatoma(5%), and malignant thymoma(5%), in order. From the percutaneous pericardial biopsy, the authors confirmed 36% by finding two cases of malignancy and two cases of tuberculosis. On the other hand, only one case was confirmed in cytology. These result in a rather low rate of diagnostic confirm. There were 8 cases of complication : hypotension(8.2%), premature ventricular contraction(6.1%) and ventricular tachycardia (2.0%) without death cases. In percutaneous pericardial biopsy, only two cases of hypotension were found with no death case. The result obtained from the above 11 cases of percutanous pericardial biopsy is not enough to make conclusive statement concerning rate of diagnostic confirmation and complication. We expect better results by examining more cases in the future.
Adenocarcinoma ; Biopsy* ; Cardiomegaly ; Diagnosis ; Electrocardiography ; Estrogens, Conjugated (USP) ; Hand ; Heart ; Humans ; Hypotension ; Lung ; Neck ; Pericardial Effusion ; Pericardiocentesis* ; Physical Examination ; Stomach ; Tachycardia, Ventricular ; Tuberculosis ; Veins

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

Background: /Aim: Since the introduction of laparoscopy for liver resection in the 1990s, the performance of laparoscopic liver resection (LLR) has been steadily increasing. However, there is currently no data on the extent to which laparoscopy is used for liver resection. Herein, we investigated the extent to which laparoscopy is performed in liver resection and sought to determine whether surgeons prefer laparoscopy or laparotomy in the posterosuperior (PS) segment. Methods: For this retrospective observational study, we enrolled patients who had undergone liver resection at the Samsung Medical Center between January 2020 and December 2021. The proportion of LLR in liver resection was calculated, and the incidence and causes of open conversion were investigated. Results: A total of 1,095 patients were included in this study. LLR accounted for 79% of the total liver resections. The percentage of previous hepatectomy (16.2% vs. 5.9%, P<0.001) and maximum tumor size (median 4.8 vs. 2.8, P<0.001) were higher in the open liver resection (OLR) group. Subgroup analysis revealed that tumor size (median 6.3 vs. 2.9, P<0.001) and surgical extent (P<0.001) in the OLR group were larger than those in the LLR group. The most common cause of open conversion (OC) was adhesion (57%), and all OC patients had tumors in the PS. Conclusions We investigated the recent preference of practical surgeons in liver resection, and found that surgeons preferred OLR to LLR when treating a large tumor located in the PS.

PURPOSE: Among the cell adhesion molecules, alpha-catenin and E-cadherin play an important part in maintaining normal cell structure. The change in expression of cell adhesion molecules affects the invasion and metastasis of a tumor and the prognosis for patients. In this study, we evaluated the relationship between the expression of cell adhesion molecules and the histopathologic characteristics of stage III colon cancer. METHODS: The relationship between the immunohistochemical expression of cell adhesion molecules and tumor progression were statistically analyzed in 40 patients with stage III colon cancer. RESULTS: There were no statistically significant correlations between loss of membranous alpha-catenin and E-cadherin expressions and such variables as histologic differentiation and lymph node disease based on the criteria of the American Joint Committee on Cancer (AJCC). A significant correlation, however, existed between depth of mural invasion and loss of expressions of both alpha-catenin and E-cadherin (P=0.001 and P=0.002, respectively). Expressions of both alpha-catenin and E-cadherin were also significantly decreased in patients showing liver metastases during follow-up (P=0.019 and P=0.015, respectively). CONCLUSION: Immunohistochemical analyses of alpha-catenin and E-cadherin expressions may be available as predictors for distant metastasis, especially in stage III colon cancer. Such analyses may also help to identify appropriate therapeutic strategies and the need for intensive follow-up in patients with stage III colon cancer.
alpha Catenin ; Cadherins ; Cell Adhesion Molecules ; Colon ; Colonic Neoplasms ; Follow-Up Studies ; Humans ; Joints ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis