The use of self-expanding metal stent has been widely reported that its utility can make a palliative decompression treatment and one stage operation without doing colostomy in the patient with unresectable and resectable obstructive colorectal cancer, respectively. It, however, can sometimes cause complications such as intestinal perforation. We report that the conservative treantment could be possible without removing stent or performing laparotomy in case of intestinal perforation during chemoradiotheraphy after insert of stent for relieving colonic obstruction in the 53 years old female patient with stage IV rectal cancer.
Colon ; Colorectal Neoplasms ; Colostomy ; Decompression ; Female ; Humans ; Intestinal Perforation ; Laparotomy ; Middle Aged ; Rectal Neoplasms* ; Stents*

The pathologic standards of multiple primary malignant neoplasms are : 1) Each tumor should be pathologically malignant. 2) Each tumor should be an independent malignancy, and not the result of submucosal or intraepidermal malignant changes. 3) Additional malignancies should not be metastatic. Multiple primary malignant neoplasms which have these standards have been studied continuously, no conclusive evidence for causal relationship has been established. Especially, many reports on the association of breast cancer with thyroid disease or salivary gland tumors have been published, but without any definite evidence. In 1984, Dr. Schenker, however, declared that during an 18-year study, 10,302 cases of breast carcinomas were diagnosed, and, of these, 984 patients(8%) had multiple primary malignant tumors. A significantly higher than expected incidence of second primary cancers occurred at the following five sites : the opposite breast, the salivary glands, the uterine corpus, the ovaries, and the thyroid. The authors report one example of Grave's disease and an other example of pleomorphic adenoma in breast cancer patients.
Adenoma, Pleomorphic ; Breast Neoplasms* ; Breast* ; Female ; Humans ; Incidence ; Neoplasms, Second Primary ; Ovary ; Salivary Glands ; Thyroid Diseases ; Thyroid Gland

The increase in size of lymph node on Ct scan is the single most important finding of lymphadenopathy. The purpose of this study was to evaluate the size of mediastinal lymph nodes in patients with idiopathic pulmonary fibrosis with no evidence of malignancy or current infection. CT scans of 70 patients (16 with conventional CT and 54 with high-resolution CT) were assessed for lymph node size and locations. The duration of symptoms, and the extent and patterns of the parenchymal lung disease on CT scans were correlated with lymph node enlargement. In 54 of 70 patients, more than one lymph nodes were larger than 1-1.5cm. The prevalence of mnode enlargement increased significantly with a longer duration of symptom (p=0.001), larger extent of the disease (p=0.043), and with a greater proportion of honeycomb pattern (p=0.0344). Right paratracheal, subcarinal, right tracheobronchial, and paraesophageal nodes were the most common sites of nodes enlargement. In conclusion, mediastinal lymph node enlargement is common in patients with idiopathic pulmonary fibrosis and is more frequently seen in patients with a longer duration of clinical symptoms, greater extent of the disease, and with a larger proportion of honeycomb pattern.
Humans ; Idiopathic Pulmonary Fibrosis* ; Lung Diseases ; Lymph Nodes* ; Lymphatic Diseases ; Prevalence ; Tomography, X-Ray Computed*

Primary osteosarcoma of the breast is very rare. There have been no previously reported cases in Korea. In this paper, a case of primary osteosarcoma of the breast is reported. It should be distinguished from a carcinoma with extensive osseous metaplasia. Immunohistochemical and ultrastructural studies proved that the lesion, in the absence of epithelial differentiation, was a primary osteosarcoma of the breast rather than a carcinoma with extensive osseous metaplasia. Diagnostic aspects and treatment are discussed and a literature review is given.
Breast* ; Korea ; Metaplasia ; Osteosarcoma*

No abstract available.
Lymphoma*

OBJECTIVE: to determine the frequency of the multiple consecutive rib fracture after blunt chest trauma. DESIGN, MATERIALS, AND METHODS: We retrospectively reviewed all the radiographs and medical charts of 87 patients with rib fractures after blunt chest trauma. Rib fractures were divided into single aud multiple. The multiple rib fractures were subclassified as consecutive, interrupted continuous, or random. RESULTS: Thirteen cases of single and 83 cases of multiple rib fractures were present. Among the 83 cases of multiple fractures, there were 73 cases (88%) of consecutive fractures, 5 cases (6%) of interrupted continuous fractures and 5 cases (6%) of random fractures. CONCLUSION: Among the multiple rib fractures consecutive rib fractrues are much more common than noncontiguous rib fractures. We recommend that if one find an apparently nonfractured rib between contiguously fractured upper and lower ribs, one should meticulously search for possible fracture of an apparently normal rib with high-index of suspicion.
Humans ; Retrospective Studies ; Rib Fractures* ; Ribs* ; Thorax*

AIMTo investigate the antioxidant effects of Morinda officinalis (Morindae radix, MR) on H(2)O(2)-induced oxidative stress in cultured mouse TM3 Leydig cells.

METHODSWe carried out 2,2-diphenyl-1-picrylhydrazyl free radical scavenging, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, lipid peroxidation, testosterone enzyme immunoassay, superoxide dismutase (SOD), and catalase (CAT) assays in Leydig TM3 cells.

RESULTSMR showed a 47.8% 2,2-diphenyl-1-picrylhydrazyl radical scavenging effect in TM3 cells with no significant cytotoxicity. Oxidative stress was induced in TM3 cells with 100 micromol H(2)O(2), and treatment of the cells with 250 microg/mL MR showed the most significant protective effect (64%, P < 0.001) in the cell viability assay with a decreased lipid peroxidation level (1.75 nmol/mg protein, P < 0.05), increased testosterone production (43.5 pg/mL), and improvements in SOD activity (7.49 units of SOD/mg protein, P < 0.001) and CAT activity (74.6 units of CAT/mg protein, P < 0.001).

CONCLUSIONThese findings indicate that MR, as an antioxidant, protects functions of cultured mouse TM3 Leydig cells from H(2)O(2)-induced oxidative stress.

Animals ; Catalase ; metabolism ; Cell Survival ; drug effects ; Cells, Cultured ; Hydrogen Peroxide ; adverse effects ; Leydig Cells ; cytology ; drug effects ; metabolism ; Lipid Peroxidation ; drug effects ; Male ; Mice ; Morinda ; Oxidative Stress ; drug effects ; Plant Extracts ; pharmacology ; RNA, Messenger ; metabolism ; Superoxide Dismutase ; metabolism ; Testosterone ; metabolism

Ankylosing spondylitis is a chronic and systemic disease invloving the axial skeleton. In patient with involved cervical spine of the ankylosing spondylitis, endotracheal intubation by direct laryngoscope may be difficult or impossible because they have a limitation of cervical movement and anatomical anomalies. Additionally, ossification of the interspinous ligaments and the formation of bony bridges (syndesmophytes) between vertebrae, resulting in a classic "bamboo spine" appearance make difficult or impossible placement of an epidural or spinal needle. We report a case of a patient with long standing ankylosing spondylitis who underwent revision arthroplasty of the hip using combined continuous psoas compartment block and sciatic nerve block.
Arthroplasty* ; Hip* ; Humans ; Intubation, Intratracheal ; Laryngoscopes ; Ligaments ; Needles ; Sciatic Nerve* ; Skeleton ; Spine ; Spondylitis, Ankylosing*

A prospective randomised trial was performed to assess the diagnostic accuracy according to the time interval and the efficacy of endoscopic injection of hypertonic saline-epinephrine(HS- E)solution, consisting of 3.5% sodium chloride with 0.0045% epinephrine, for actively bleeding peptic ulcers, exposed vessel or blood clot on ulcer bed, or Mallory-Weiss tear. Over 24 month, emergency endoscopy in 180 patients admitted for upper gastrointestinal hemorrhage identified 51 patients with nonvariceal hemorrhage. The causes of bleeding were; gastric ulcer in 32; duodenal ulcer in 13; gastric cancer in 4; Mallory-Weiss tear in 2. With this method, the hemostatic effect was permanent in 40 cases(84.3%), temporary in 9 cases(11.8%), and failed in 2 cases(3.9%). By applying this method, the rate of emergency operation for patients with bleeding from the upper gastrointestinal tract was significantly reduced from 20.0% (8/40)to 3.9%(2/51)(p<0.05). Emergency endoscopy in acute UGI bleeding increases the accuracy of detection of actual bleeding sites(p<0.05), but if the endoscopic procedure was performed within 48 hours, the hemostatic rate was not affected(p<0.05). We concluded that hypertonic saline-epinephrine injection method could provide a simple maneuver with reasonable cost, high safety, and satisfactory hemostatic efficacy in the treatment of nonvariceal upper gastrointestinal bleeding.
Duodenal Ulcer ; Emergencies ; Endoscopy ; Epinephrine* ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Hemostasis ; Humans ; Mallory-Weiss Syndrome ; Peptic Ulcer ; Prospective Studies ; Sodium Chloride ; Stomach Neoplasms ; Stomach Ulcer ; Ulcer ; Upper Gastrointestinal Tract*

Currently, endoscopic injection sclerotherapy(EIS) is the most widely used method for treating and eradicating acutely bleeding esophageal varices in repeated sessions, but may be associated with some undesirable local and systemic complications. (continue...)
Esophageal and Gastric Varices* ; Esophagus ; Hemorrhage ; Hemostasis ; Ligation* ; Sclerotherapy* ; Varicose Veins