No abstract available.
Replantation*

PURPOSE: With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. MATERIALS AND METHODS: We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. RESULTS: lntrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107(64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII :26(15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. CONCLUSION: These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm.
Angiography* ; Arteries ; Hepatic Artery* ; Infusions, Intravenous ; Liver Neoplasms ; Portography ; Retrospective Studies ; Tomography, X-Ray Computed*

PURPOSE: With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. MATERIALS AND METHODS: We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. RESULTS: lntrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107(64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII :26(15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. CONCLUSION: These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm.
Angiography* ; Arteries ; Hepatic Artery* ; Infusions, Intravenous ; Liver Neoplasms ; Portography ; Retrospective Studies ; Tomography, X-Ray Computed*

No abstract available.
Chickens* ; Yolk Sac*

Solitary fibrous tumors (SFTs) are an uncommon neoplasm characterized by the proliferation of spindle cells. The diagnostic criteria of malignant solitary fibrous tumors (MSFTs) include high cellularity, high mitotic activity (4>10 HPF), pleomorphism, hemorrhage and necrosis. This tumor frequently involves the pleura and MSFTs of retroperitoneum mimicking gastric submucosal tumor are very rare. We report a rare case of MSFT that presented as a gastric submucosal tumor. A gastroscopic examination showed a large bulging mucosa in the gastric body. Abdominal computed tomography revealed a well-defined heterogeneous enhancing mass between the left hepatic lobe and gastric body. Surgical resection was performed and histologic features were consistent with a MSFT.
Antigens, CD34/metabolism ; Gastroscopy ; Humans ; Male ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2/metabolism ; Retroperitoneal Neoplasms/*diagnosis/pathology/surgery ; Solitary Fibrous Tumors/*diagnosis/pathology/surgery ; Stomach Neoplasms/diagnosis ; Tomography, X-Ray Computed

Despite the fact that the anticholinesterases, mainly neostigmine, has been used for many years to antagonize a nondepolarizing neuromuscular blockade, until recently nothing was known about their pharmacokinetics and dynamics in anesthetized patients. This deficiency was largely due to lack of a suitable analytic technique to measure the concentration of these drugs in body fluids, most importantly serum. Recently it was developed a method by which the serum concentrations of neostigmine, pyridostigmine, edrophonium and their metabolities can be measured. Recently,k pyridostigmine and edrophonium have gained popularity to use for reversing a nondepolarizing muscle relaxants. We have studied newly introduced vecuronium effects and its reversal with pyridostigmine. The results were as follows: 1) Spontaneous recovery index by vecuronium 0.1mg/kg was 620.8 sec. 2) Recovery index by the pyridostigmine 160ug/kg reversal was significantly shortened as 134.0sec in vecuronium 0.1mg/kg block. 3) Tetanic stimulation (100Hz, 5sec) was sustained after 75% recovery of twitch height by pyridostigmine 160ug/kg reversal.
Body Fluids ; Cholinesterase Inhibitors ; Edrophonium ; Humans ; Neostigmine ; Neuromuscular Blockade* ; Pharmacokinetics ; Pyridostigmine Bromide* ; Rabbits* ; Vecuronium Bromide*

PURPOSE: The stomach is the most frequent site of gastrointestinal stromal tumor (GIST). Surgery remains the only curative treatment for GIST. Resection needs to ensure tumor free margin without lymphadenectomy. Thus partial gastric resection is the treatment of choice for gastric GIST. This study aims to review clinical characteristics between open and laparoscopic wedge resection group and evaluate safety and efficacy of laparoscopic wedge resection. METHODS: Between 1997 and 2008, 74 consecutive patients undergoing open or laparoscopic wedge resection of gastric GISTs were identified in a retrospectively collected database. Preoperative and postoperative variables were analyzed. RESULTS: Wedge resection with negative margin was performed in 74 patients. Laparoscopic wedge resection was performed 19 patients. Open wedge resection was performed in 55 patients. Mean tumor size of laparoscopic group was 2.7 cm (range 0.4~6.0) and open group was 4.4 cm (range 0.4~23.0). Mean operation time of laparoscopic group was 150.0 minutes (range 80~240), and open group was 164.6 minutes (range 75~360). Mean hospital stay of laparoscopic group was 7.11 days (range 3~19), and open group was 9.38 days (range 6~20). There were no significant survival differences between groups. CONCLUSION: A laparoscopic wedge resection of gastric GIST is associated with short hospitalization and not inferior to open wedge resection in terms of morbidity and mortality. The long-term outcomes between laparoscopic and open wedge resection group in our study were no significant survival differences. Long-term and prospective randomized study should be performed to confirm oncological safety of laparoscopic wedge resection.
Dietary Sucrose ; Gastrointestinal Stromal Tumors ; Hospitalization ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Retrospective Studies ; Stomach

PURPOSE: In 2010, the new UICC/AJCC TNM classification for gastric cancer was declared. The new classification for gastric cancer has several changes from the 6th classification. We evaluated the prognostic values and differences according to the new UICC/AJCC TNM classification. METHODS: From 2000 to 2004, 1,196 patients who underwent curative resection with D1+beta or more lymph node dissection and with 15 or more lymph nodes retrieved were studied retrospectively. We analyzed clinical characteristics and survival outcomes retrospectively from medical records. RESULTS: According to UICC/AJCC 7th TNM classification, the 5-year survival rate (5YSR) of each group for depth of invasion and node metastasis were significantly different. The 5YSR of stage II in 6th classification was 82.4% and the 5YSR of stage IIa and IIb in 7th classification were 92.2% and 82.9%. The 5YSR of stage IIIa and IIIb in 6th classification were 56.3% and 33.0%. The 5YSR of stage IIIa, IIIb and IIIc in 7th classification were 72.7%, 48.4% and 26.1%. In our Cox regression multivariate analysis, N stage of the 6th UICC/AJCC TNM classification was the main independent prognostic factor. CONCLUSION: N stage of the 6th UICC/AJCC TNM classification is a more reliable prognostic factor than N stage of the 7th UICC/AJCC TNM classification. Further study should be performed to confirm the appropriateness of N stage TNM classification for gastric cancer.
Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

Multiple primary malignancy was reported firstly by Billroth in 1889. Recently, multiple primary malignancies are considered to increase due to improved survival rate of cancer patients, advanced diagnostic tools, and increased use of chemotherapy and radiotherapy. In Korea, several cases of triple primary malignancies were reported. However, four primary malignancies in gastro-intestinal tract was rarely reported. Recently, we experienced a 70 year-old male who was diagnosed with metachronous four primary malignancies in rectum, ascending colon, stomach, and ampulla of Vater. We report this rare case of metachronous four primary malignancies with a review of literature.
Adenocarcinoma/*diagnosis/pathology/surgery ; Adenocarcinoma, Mucinous/diagnosis/surgery ; Aged ; Ampulla of Vater/*pathology ; Colonic Neoplasms/diagnosis/surgery ; Common Bile Duct Neoplasms/*diagnosis/pathology/surgery ; Gastrointestinal Neoplasms/*diagnosis/pathology/radiography ; Humans ; Male ; Neoplasms, Second Primary/*diagnosis/pathology ; Rectal Neoplasms/diagnosis/surgery ; Stomach Neoplasms/diagnosis/pathology/surgery ; Tomography, X-Ray Computed

BACKGROUND AND PURPOSE: The pathogenesis of mitochondrial disease (MD) involves the disruption of cellular energy metabolism, which results from defects in the mitochondrial respiratory chain complex (MRC). We investigated whether infants with MRC I defects showed ultrastructural changes in skeletal muscle. METHODS: Twelve infants were enrolled in this study. They were initially evaluated for unexplained neurodegenerative symptoms, myopathies, or other progressive multiorgan involvement, and underwent muscle biopsies when MD was suspected. Muscle tissue samples were subjected to biochemical enzyme assays and observation by transmission electron microscopy. We compared and analyzed the ultrastructure of skeletal muscle tissues obtained from patients with and without MRC I defects. RESULTS: Biochemical enzyme assays confirmed the presence of MRC I defects in 7 of the 12 patients. Larger mitochondria, lipid droplets, and fused structures between the outer mitochondrial membrane and lipid droplets were observed in the skeletal muscles of patients with MRC I defects. CONCLUSIONS: Mitochondrial functional defects in MRC I disrupt certain activities related to adenosine triphosphate synthesis that produce changes in the skeletal muscle. The ultrastructural changes observed in the infants in this study might serve as unique markers for the detection of MD.
Adenosine Triphosphate ; Biopsy ; Electron Transport* ; Energy Metabolism ; Enzyme Assays ; Humans ; Infant* ; Lipid Droplets ; Microscopy, Electron, Transmission ; Mitochondria ; Mitochondrial Diseases ; Mitochondrial Membranes ; Muscle, Skeletal* ; Muscular Diseases