Leiomyosarcoma of small intestine is an uncommon tumor, comprising less than 20 percent of all primary malignant tumors of small intestine. Duodenal leiomyosarcoma is rare disease which amount to about 20 percent of all small bowel malignancy but potentially curable tumors often diagnosed at an advanced age, so its five-year survival following resection approximates 50% in reported series. Recently, several cases of leiomyosarcomas of duodenum were diagnosed by hypotonic duodenograhy in Korea. We experienced a woman with duodenal leiomyosarcoma that was diagnosed by endoscopic duodenal biopsy and received currative resection of the tumor(Whipple's operation). We report the case with review of the literatures.
Biopsy ; Duodenum ; Endoscopy ; Female ; Humans ; Intestine, Small ; Korea ; Leiomyosarcoma* ; Rare Diseases

PURPOSE: To compare standard laparoscopy-assisted Billroth I gastrectomies including standard lymph node dissection (LABIG) with hand-assisted laparoscopic surgery with the HandPort system (HALS) for the removal of early gastric cancers (EGC). METHODS: A prospective study was performed on 26 patients of EGC at Ewha Womans University Mok-Dong Hospital from July 1999 to August 2001. Seventeen patients (Group L) received LABIG using conventional laparoscopy-assisted methods and 9 patients received LABIG using HALS (Group H). We used staplers for the anastomosis, and a standard D2 lymph node dissection was done with ultrasonic shears or electrocautery. RESULTS: In group L, pathologic reports revealed 14 EGC (stage IA 14 cases), and 3 pm cancers (stage IB 1 case, II 2 cases). In group H, there were 9 early gastric cancers (stage IA 8 cases, IB 1 case). Significant differences (P<0.05) were present between group L and H in regards to the number of harvested lymph nodes (30.8 vs 18.9), estimated blood loss (462.1 vs 286.7 ml) and postoperative transfusion amounts (0.59 vs 0 unit). There were no differences in the mean operating time, distance from the lesion to the resection margin, postoperative leukocyte count, frequencies for pain control, wound size, time to diet, weight loss, serum protein, and postoperative hospital stay. Complications were present in 1 case in group L (enterocutaneous fistula) and 1 case in group H (gastric atony). There was one conversion to open surgery in group H. CONCLUSION: LABIG including standard lymph node dissections with both standard laparoscopic surgery and HALS were performed with equal outcome. The choice of surgical method depends on the characteristics of the lesion and the patient's physical factors.
Conversion to Open Surgery ; Diet, Reducing ; Electrocoagulation ; Female ; Gastrectomy* ; Gastroenterostomy* ; Hand-Assisted Laparoscopy* ; Humans ; Laparoscopy ; Length of Stay ; Leukocyte Count ; Lymph Node Excision ; Lymph Nodes ; Prospective Studies* ; Stomach Neoplasms* ; Ultrasonics ; Wounds and Injuries

No abstract available.
Goats* ; Skeleton*

No abstract available.
Goats* ; Mesencephalon* ; Periaqueductal Gray* ; Somatostatin*

Severely worn dentition causes various complications such as loss of tooth structure, discoloration, pulp complications and loss of function and aesthetics. In this case, the patient showed particularly severe attrition in the anterior teeth and lack of space for restoration. The amount of vertical dimension was determined based on the diagnostic wax up, and the patient’s adaptation was evaluated by using a removable occlusal splint for 6 weeks. Thereafter, the coordination of the muscular nervous system, aesthetics, temporomandibular joint were re-evaluated for 3 months by restoring the fixed provisional restoration. Through the above treatment process, the final restoration was completed with full mouth fixed prosthesis using monolithic zirconia, and functionally and aesthetically stable results were obtained.

Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

BACKGROUND: Recently elderly people have increased in Korea and increased demands of medical service. This study was carried out to identify diseases and health service utilization patterns of geriatric inpatients to provide better understanding and basis planning to meet the needs of expanding geriatric population. METHOD: We use data of `Patient Survey in Korea` in 1999 and analyzed characteristics of disease structure and utilization patterns of health care service of 54,013 cases of discharged patients aged 65 years or more. RESULT: The proportion of the elderly in total discharged patients is 14.7%. Male to female ratio is 1:1.3 and most common age group was between 65 and 69 years old. 84.2% of elderly patients were admitted at secondary or tertiary health care facilities. The most common disease in geriatric inpatients is malig- nancy in male and vascular disease in female. The average duration of hospitalization is 14.2 days. They stay longer than the nation wide average hospital length and stay longest when they are admitted by mental and behavioral disorders. CONCLUSION: Geriatric patients are admitted mostly with chronic degenerative diseases such as neoplasm and vascular disease. Elders prefer to be admitted to tertiary hospitals and oriental hospitals. They stay more in hospital.
Aged ; Delivery of Health Care ; Female ; Health Services* ; Hospitalization ; Humans ; Inpatients* ; Korea ; Male ; Tertiary Care Centers ; Vascular Diseases

Hereditary hemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu disease is an autosomal dominant disorder characterized by repeated episodes of bleeding. Multiple telangiectases consisting of thin-walled, dilated vascular channels with arteriovenous communication may involve, for example, mucocutaneous tissue, the gastrointestinal tract, and the liver, lung, and brain. We report the imaging findings of two cases of HHT involving arteriovenous malformation of both the lungs and liver, a rare condition. Chest radiography revealed a round mass, while helical CT showed a feeding artery and draining vein with arteriovenous malformation in the lung. Color Doppler sonography revealed an enlarged and tortuous hepatic artery with high systolic velocity. CT demonstrated an enlarged hepatic artery, arteriovenous shunt, and early draining hepatic vein in the liver. Celiac angiography showed arteriovenous malformation.
Angiography ; Arteries ; Arteriovenous Malformations* ; Brain ; Gastrointestinal Tract ; Hemorrhage ; Hepatic Artery ; Hepatic Veins ; Liver* ; Lung* ; Radiography ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis ; Thorax ; Tomography, Spiral Computed ; Veins

We evaluated after-cataract, capsular opacification, following combined lens removal with phacoemulsification or pars plana lensectomy, pars plana vitrectomy and primary or secondary IOL implantation on 34 eyes followed up more than 3 years.For the lens removal 23 eyes had pars plana lensectomy ad 11 eyes phacoemulsification. Nd-YAG capsulotomy is needed on 8/34 eyes(25.5%). Nd-YAG capsulotomy was performed on 3/23 eyes(13%) of pars plana lensectomy and on 5/11 eyes(45.5%) of phacoemulsification. Nd-YAG capsulotomy was performed to 7/22 eyes(31.8%) of primary IOL implantation and 1/12 eyes(8.3%) of secondary IOL implantation. Most patients had systemic vascular disease such as diabetes or hypertension.In conclusion, combined pars plana lensectomy, pars plana vitrectomy and secondary IOL implantation was the least incidence of after-cataract and side effects, so this procedure was thought to be recommended for vitreoretinal surgery.
Humans ; Incidence ; Phacoemulsification ; Vascular Diseases ; Vitrectomy ; Vitreoretinal Surgery

PURPOSE: To evaluate the correlation between nuclear density measured using the Pentacam(R) (Oculus Optikgerate GmbH, Wetzlar, Germany) Scheimpflug imaging system and phacoemulsification parameters. METHODS: The nuclear density was measured using maximal nuclear density with ImageJ, Pentacam(R) nucleus staging (PNS), average value and maximal value in lens densitometry. Intraoperatively, effective phaco time (EPT) and balanced salt solution (BSS) used were noted and compared with the nuclear density calculation methods. As an index of corneal endothelial cells, the changes in cell density (CD) were compared with the nuclear density. RESULTS: Regarding EPT, maximal nuclear density with ImageJ (r = 0.379, p < 0.01) and PNS (r = 0.367, p < 0.01) were correlated positively, but the other methods were not correlated. Concerning BSS used, maximal nuclear density with ImageJ (r = 0.279, p = 0.03) and PNS (r = 0.286, p = 0.04) were positively correlated, but the other methods were not correlated. The specular microscopy showed that as the nuclear density increased, the postoperative CD tended to decrease, but without statistical significance. CONCLUSIONS: Preoperative nuclear density measurements using maximal nuclear density with ImageJ or PNS were correlated with phacoemulsification parameters.
Cell Count ; Densitometry ; Endothelial Cells ; Microscopy ; Phacoemulsification*