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*

OBJECTIVE: There have been few studies concerning the clinical pathology of malignant transformation arising from ovarian mature cystic teratoma. Thus, the objective of this study is to determine clinicopathologic factors affecting survival in this rare tumor. METHODS: From November 1992 to December 2002, 11 patients with malignant transformation arising from ovarian mature cystic teratoma were treated at Departments of Obstetric and Gynecology in Chonnam National University Hospital. Demographic characteristics, symptoms, signs, stage, mode of therapy and results of follow up were reviewed retrospectively. RESULTS: There were 11 cases of the malignant transformation of ovarian mature cystic teratomas out of 637 cases of mature cystic teratomas (1.7%). The average age was 50.6 years. Histologically, 7 out of the 11 cases were squamous cell carcinoma (63.7%). There was no specific clinical symptom but palpable abdominal mass was the most frequent complaint (5 cases, 45.4%). As for the stage of disease, 8 cases were in stage Ia (72.7%) and the other three cases were in stage Ic, IIb and IIc respectively. All the patients received surgery, and 7 of them had chemotherapy and 2 both chemotherapy and radiation therapy at the same time. All patients in stage I survived until the period of follow-up and their average survival time was 31.8 months. One patient in stage IIc died of intestinal obstruction in 9 month from the surgery and the average survival time of two patients in stage II was 8.5 months. CONCLUSION: The mechanism of the malignant formation arising in ovarian mature cystic teratomas is not clear but considering the fact that 80% of mature cystic teratomas are diagnosed during the reproductive age malignant transformation seems to be related to the long-term presence of non-removed mature cystic teratomas in abdomen. Accordingly, it is considered helpful for preventing and early detection of the malignant transformation to have regular ovary examination through pelvic ultrasonogram during the reproductive age.
Abdomen ; Carcinoma, Squamous Cell ; Drug Therapy ; Female ; Follow-Up Studies ; Gynecology ; Humans ; Intestinal Obstruction ; Jeollanam-do ; Ovary ; Pathology, Clinical ; Retrospective Studies ; Teratoma* ; Ultrasonography

Brachial plexus block is a suitable, technique for surgery of the forearm, because it provides good intraoperative anesthesia and prolonged postoperative analgesia when long-acting local anesthetics are used. An eighty-year-old male patient was admitted to our hospital for right radioulnar fracture. He had active pulmonary tuberculosis, severe valvular heart disease, hypertension, mild subarachnoid hemorrhage and a difficult airway. So, we performed an infraclavicular block to treat the fracture site and used a nerve stimulator when median nerve dital response and musculocutaneous nerve response were sought, and combined spinal-epidural block for the iliac bone graft at the same time. Regional anesthesia many advantages compared to general anesthesia in extremity operation. Peripheral nerve block and neuraxial block, when used properly in combination, should be able to replace general anesthesia in the majority of cases.
Analgesia ; Anesthesia* ; Anesthesia, Conduction ; Anesthesia, General ; Anesthetics, Local ; Brachial Plexus* ; Extremities ; Forearm ; Heart Valve Diseases ; Humans ; Hypertension ; Male ; Median Nerve ; Musculocutaneous Nerve ; Peripheral Nerves ; Subarachnoid Hemorrhage ; Transplants* ; Tuberculosis, Pulmonary