Leiomyosarcoma of the rectum is a extremely rare disease without well documented report on its management and prognosis. The most complicated problem lies on the correct diagnosis. Many pathologic and histologic criteria have been proposed to make it clear. The treatment of rectal leiomyosarcoma is controversial. Some authors recommand wide local excison for low-grade tumors as much as 2 cm in diameter. However, radical abdominoperineal resection is the procedure of choice. Leiomyosarcoma of the rectum is resistant to radiotherapy, and no single effective chemotherapeutic drug has been found yet, although adriamycin is effective in one third of all cases. The local recurrence rate was much higher in patients receiving wide local excision and the overall 5-year or 10-year survival rate is similar. We report a case of rectal leiomyosarcoma and review the literature.
Diagnosis ; Doxorubicin ; Humans ; Leiomyosarcoma* ; Prognosis ; Radiotherapy ; Rare Diseases ; Rectum* ; Recurrence ; Survival Rate

PURPOSE: Lymph node metastasis is an important factor for predicting the prognosis of colorectal cancer patients. However, approximately 60% of patients do not receive adequate lymph node evaluation (less than 12 lymph nodes). In this study, we identified a more effective tool for predicting the prognosis of patients who received inadequate lymph node evaluation. MATERIALS AND METHODS: The number of metastatic lymph nodes, total number of lymph nodes examined, number of negative metastatic lymph nodes (NL), lymph node ratio (LR), and the number of apical lymph nodes (APL) were examined, and the prognostic impact of these parameters was examined in patients with colorectal cancer who underwent surgery from January 2004 to December 2011. In total, 806 people were analyzed retrospectively. RESULTS: In comparison of different lymph node analysis methods for rectal cancer patients who did not receive adequate lymph node dissection, the LR showed a significant difference in overall survival (OS) and the APL predicted a significant difference in disease-free survival (DFS). In the case of colon cancer patients who did not receive adequate lymph node dissection, LR predicted a significant difference in DFS and OS, and the APL predicted a significant difference in DFS. CONCLUSION: If patients did not receive adequate lymph node evaluation, the LR and NL were useful parameters to complement N stage for predicting OS in colon cancer, whereas LR was complementary for rectal cancer. The APL could be used for prediction of DFS in all patients.
Colonic Neoplasms ; Colorectal Neoplasms* ; Complement System Proteins ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Methods* ; Neoplasm Metastasis ; Prognosis* ; Rectal Neoplasms ; Retrospective Studies

No abstract available.
Colon* ; Colonic Neoplasms* ; Electrons*

Spigelian hernia is an uncommon hernia of the ant. abdominal wall. Because of its insidious nature and nonspecific physical findings, the diagnosis of this hernia is often not made. Typically, the hernia orifice is small, and strangulation of the contents of the hernial sac can occur. Computed tomography permits the distinction between Spigelian hernia and other anterial abdominal wall or intraabdominal masses. Spigelian hernia requires surgical correction to prevent complication of acute abdomen with strangulation or incarceration. The typical site of a Spigelian hernia is at the level of the semicircular fold of Douglas known as the arcuate line. Spigelian hernia can occur above the umbilicus, high Spigelian hernia, but its very unusual site. We report a case of Spigelian hernia on upper abdomen and review the literature.
Abdomen* ; Abdomen, Acute ; Abdominal Wall ; Ants ; Diagnosis ; Hernia* ; Umbilicus

Intraperitoneal carcinomatosis accounts for 25~35% of recurrences of colorectal cancer, and peritoneal carcinomatosis from colorectal cancer has been regarded as a lethal condition. However, a combination of aggressive cytoreductive surgery and intraperitoneal chemotherapy has been tried and appears to be beneficial in selected patients. The primary goal of cytoreductive surgery is to remove all visible tumor within the peritoneal cavity. The goal of intraperitoneal chemotherapy is to eradicate the microscopic residual tumor and to prevent its recurrence. There are various ways to perform intraperitoneal chemotherapy. One is postoperative intraperitoneal chemotherapy, and another is intraoperative hyperthermic chemotherapy during surgery. Hyperthermia increases the penetration of chemotherapy into tissues and the level of chemotherapy cytotoxicity. The timing of surgery in cases of intraperitoneal chemotherapy and the optimal dosage of drugs must be evaluated in further studies. In colorectal cancer, the peritoneum should be regarded as an intra-abdominal organ, like the liver. Therefore, intraperitoneal carcinomatosis must be treated by using a combination of aggressive surgical treatment and intraperitoneal chemotherapy. Eventually, the long-term overall survival will be increased.
Carcinoma* ; Colorectal Neoplasms* ; Drug Therapy ; Fever ; Humans ; Liver ; Neoplasm, Residual ; Peritoneal Cavity ; Peritoneum ; Recurrence

No abstract available.
Colorectal Neoplasms* ; Humans ; Radiotherapy*

The authors present two cases of granular dystrophy of the cornea developed in 47-year-old house wife and her 27-year-old son respectively. The mother first noticed diminished vision at 23 years of age and was diagnosed as corneal dystrophy at the age 28. Her son was diagnosed as corneal dystrophy at his age 16. The disease has run a slow, torpid course, progressing without dramatic incident and inflammatory symptoms, but attack of slight epiphora and photophobia occurred as age advanced. The corneal change was characterized by the presence of miliary sized milk-white spots in the stroma mainly at the central area of the cornea. The visual acuity was progressively deteriorated over the year but not gravely reduced allowing useful activities.
Adult ; Cornea* ; Humans ; Lacrimal Apparatus Diseases ; Middle Aged ; Mothers ; Photophobia ; Spouses ; Vision, Low ; Visual Acuity

Colorectal cancer is the fourth most common malignant disease in Korea. Until recently, fluorouracil was the only effective chemotherapeutic agent for colorectal cancer. But during the past decades, the Food and Drug Administration (FDA) has approved four new drugs for advanced colorectal cancer. Two of them (irinotecan and oxaliplatin) are cytotoxic drugs, whereas the other two (bevacizumab and cetuximab) are monoclonal antibodies against molecular targets. Bevacizumab, a humanized antibody directed against the vascular endothelial growth factor, has been examined in combination with chemotherapeutic agents in several clinical trials in patients with advanced colorectal cancer. According to the phase III randomized controlled clinical trial, the addition of bevacizumab to IFL (irinotecan, 5-FU, leucovorin) led to an impressive, statistically significant increase in the rate of response and prolongation in median overall survival. Recently, a statistically significant prolongation in median survival was also reported with the addition of bevacizumab to FOLFOX4 (oxaliplain, 5-FU, leucovorin) regimen in patients with advanced colorectal cancer. Cetuximab is a monoclonal antibody against the epidermal growth factor receptor. It appears to be synergistic with irinotecan, even in irinotecan-refractory tumors. The most common side effect of cetuximab is acne-like rash, and interestingly, the development and severity of it have been correlated with an increased likelihood of an objective response. In the future, additional research will be required to define the optimal selection and scheduling of available cytotoxic and biologic treatment in individually tailored therapeutic strategies.
Antibodies, Monoclonal ; Bevacizumab ; Cetuximab ; Colorectal Neoplasms* ; Exanthema ; Fluorouracil ; Humans ; Korea ; Receptor, Epidermal Growth Factor ; United States Food and Drug Administration ; Vascular Endothelial Growth Factor A

Liver metastases in colorectal cancer are a frequent and lethal complication. Although hepatic resection is an effective treatment for patients with liver metastases in colorectal cancer, only 10-20% of the patients with liver metastases in colorectal cancer are indicated on hepatic resection. However, over the past several decades, liver resection has evolved as a safe and potentially curative treatment for liver metastases in colorectal cancer. Currently the absolute number of patients amenable to resection is large and is growing with better imaging, better surgery, and improvements in systemic therapies to reduce the risk of both intrahepatic and extrahepatic recurrences. The development of active chemotherapy and molecular targeted therapies, together with newer modalities like radiofrequency ablation, have expanded the indications for hepatic resection and improved survival. Also, although initially unresectable, a hepatic resection of colorectal liver metastases after down-sizing by using the above mentioned treatment modalities and chemotherapy can provide a hope for long-term survival that is similar to that of primarily resectable patients. To achieve this objective, for patients with liver metastases, a multidisciplinary team approach has become mandatory, with routine re-evaluation of patients and with adequate timing for each treatment.
Colorectal Neoplasms ; Humans ; Liver ; Molecular Targeted Therapy ; Neoplasm Metastasis ; Recurrence

In glaucoma, we need an accurate, highly reproducible analysis method for the purpose of early detection of fine glaucomatous optic nerve head change. Nowadays many investigations using confocal laser tomographic scanner (Heidelberg Retinal Tomograph ; HRT) are actively undertaken. We analyzed the optic nerve head of 479 normal eyes(male:308, female:171) with HRT, and got the mean value of each parameter in HRT. We compared the difference between men and women. We also observed the distribution of the value of each parameter in normal adult. In addition, for the parameter of rim/disc area ratio, we got the mean value in 6 divisions of optic nerve head. The range of distribution of disc area was from 1.139 mm2 to 4.512 mm2, cup area ranged from 0.104 mm2 to 2.667 mm2, and rim area was from 0.760 mm2 to 2.925 mm2. The parameter which showed difference between men and women was height variation contour. For rim/disc area ratio, the mean value of each 6 divisions were as follows: nasal inferior, 0.909; nasal, 0.908; nasal superior, 0.860; temporal inferior, 0.763; temporal 0.519; temporal superior 0.738. We can make good use of the normal parameters of HRT in Koreans for diagnosis and treatment of glaucoma.
Adult ; Diagnosis ; Female ; Glaucoma ; Humans ; Male ; Optic Disk* ; Optic Nerve* ; Retinaldehyde