Anatomical plane and fascia have been described in medical behaviors for hundreds of years since the appearance of anatomy and operation. Generally, these descriptions can be sorted into three theories, i.e. plane surgery, fascia theory and mesentery anatomy. However, these theories are difficult to satisfy the scientific paradigm that includes consistency in description, independence in validation, potential to solve practical problems, and the interaction of the above-mentioned theries. Recently, membrane anatomy was proposed as the anatomy of mesentery and its beds in broad sense. Behind it lies fascia membrane/serous membrane structure, as well as inherent life events and general order. Mesentery in broad sense is described as the fascia membrane/serous membrane in serous cavity, which envelops and suspends the organ/tissue and its feeding structures to the posterior wall of the body. Anatomy is the setting/structure, in which life events/functions occur. In the research and discussion of membrane anatomy, abiding by the scientific paradigm and upholding the scientific spirit are the only way to obtain reliable knowledge and the criterion for in-depth scientific research.
Fascia ; Humans ; Mesentery ; Serous Membrane

PURPOSE: To define the histologic correlation of the ultrsonic gastric wall layers of resected human gastric specimens. MATERIALS AND METHODS: UItrasound images of the gastric wall by using 5 or 7.5 MHz linear transducer were compared with the corresponding histologic sections of 30 surgically resected human gastric specimens. RESULTS: Five layers seen from within on ultrasound images of the normal gastric wall corresponded to (1) the acoustic interface between fluid bathing the surgical specimen and the mucosal surface and a portion of the superficial mucosa, (2) the deep mucosa including the muscularis mucosae and most of the superficial mucosa, (3) the submucosa plus the acoustic interface between the submucosa and the muscularis propria, (4) the muscularis propria minus the acoustic interface between the submucosa and the muscularis propria, and (5) the serosa and the subserosal tissue plus the acoustic interface between the serosa and the fluid bathing the surgical specimen. Ultrasonic findings in gastric carcinomas corresponded to their histopathologic findings. CONCLUSION: Histologic correlation of the ultrasonic gastric wall layers will provide us with a very useful and objective basis of gastric ultrasonography.
Acoustics ; Baths ; Humans ; Mucous Membrane ; Serous Membrane ; Transducers ; Ultrasonics* ; Ultrasonography

Mesothelioma is a neoplasm arising from the mesothelial cells lining the serous membrane such as pleura, peritoneum. and tunica vaginalis of testis. Primary malignant mesothelioma of tunica vaginalis is rare and there was no report in Korean literature yet. We report a case of a 43-year-old man with a painless palpable growing mass and histopathologically demonstrated to a malignant mesothelioma arising from the tunica vaginalis of testis.
Adult ; Humans ; Mesothelioma* ; Peritoneum ; Pleura ; Serous Membrane ; Testis*

We report an unusual case of concomitant partial laceration of bulbous urethra and transsection of left crura of corpus cavernosum caused by a stab wound to the upper scrotum. The serosa and part of rectal wall was also damaged. After exploration and surgical correction, the outcome was successful.
Lacerations ; Rupture* ; Scrotum ; Serous Membrane ; Urethra ; Wounds, Stab*

Intestinal lymphangiectasia is characterized by protein- losing enteropathy, and is diagnosed by a small bowel biopsy demonstrating dilated lymphatics in the mucosa, submucosa and serosa in the absence of coexistent inflammation. We report a case of primary intestinal lymphangiectasia that occurred in a 2-year-6-month-old girl who was treated successfully with antiplasmin and octreotide. Initially, the patient was treated with a lipid restriction diet with medium chain triglyceride oil, but her symptoms were not relieved. This case shows that antiplasmin and octreotide therapy might be useful for treating refractory primary intestinal lymphangiectasia.
Biopsy ; Diet ; Female ; Humans ; Inflammation ; Mucous Membrane ; Octreotide* ; Serous Membrane ; Triglycerides

Intramural duodenal hematoma (IDH) is a quite rare disese entity which results from the collection of blood and body fluid between mucosa and serosa. Various degrees of duodenal obstruction may be caused by IDH as it gradually enlarges and compresses the mucosa against the opposite side of duodenum. The most common cause of IDH is blunt abdominal trauma and the spontaneous IDHs are generally casused by coagulation disorder such as blood dyscrasia, anticoagulation treatment or pancreaticoduodenal aneurysm. The diagnosis is usually made by the typical imaging on abdominal computed tomographic scan with a previous history of blunt abdominal trauma. For spontaneous IDH without coagulation disorder, an abdominal angiogram may be considered to exclude vascular anomalies. Medical treatment is recommended unless the associated visceral injuries require immediate laparotomy. Here, we report a case of acute duodenal obstruction due to IDH which had resolved completely without an operative management.
Aneurysm ; Body Fluids ; Diagnosis ; Duodenal Obstruction* ; Duodenum ; Hematoma* ; Laparotomy ; Mucous Membrane ; Serous Membrane

According to Moertel's classification, synchronous multiple gastric cancer is eonsidered to be a sort of multiple primary cancer, The clinical signifieance of multiplicity in gastric cancer was its location relative to the resection line. Compared with patients with single gastric cancer, multiple gastric cancer were more frequently found among the older men, and they were more commonly found in early gastric cancer. The frequency of multifocality in gastric cancer is 2.2-9% in the world literature reports and is increasing recently, with advance in the diagnostic method of gastric cancer. However, synchronous multiple gastric cancer which has more than four foci is rare. In Korea, there has been only one case reported about quadruple gaatric cancer. Recently, we experienced a case of a 58-year-old male patient with synchronously developed-quadruple gastric cancer on the body of stomach, for whom radical total gastrectomy and esophagojejunostomy was done. All of them were moderately differentiated adenocarcinoma. The mapping about four lesions showed that Borrmanin type III AGC extending to the serosa was placed on the posterior wall of higher body; EGC IIc invading the submucosa, the anterior wall of mid body, EGC III confined to the mucosa, the lesser curvature side of mid to lower body; EGC III localizing to the mucosa, the posterior wall of lower body. So we reported this case with a review of literatures.
Adenocarcinoma ; Classification ; Gastrectomy ; Humans ; Korea ; Male ; Middle Aged ; Mucous Membrane ; Serous Membrane ; Stomach ; Stomach Neoplasms*

BACKGROUND: The aim of this study is to elucidate the relationship between the CD44s and CD44v6 expression level and the biological characteristics of a gastric carcinoma. METHODS: CD44s and CD44v6 expression was investigated in 56 gastric carcinomas, 18 dysplasias, and 22 normal mucosae by immunohischemical staining. RESULTS: The CD44s and CD44v6 expression rates in gastric carcinomas, dysplasia, and normal mucosae were 80.3% and 83.9%, 72.2% and 77.8%, and 13.6% and 4.5%, respectively. Statistical analysis showed significant difference after comparing a gastric carcinomas and dysplasia to the normal mucosae (p<0.001). The CD44s and CD44v6 expression rates in the cases with invasion to the muscle proper and serosa were 60.7% and 57.1%, and 82.4% and 88.2%, respectively. Both showed a significant statistical difference compared to the expression rates in the cases with invasion to the mucosae and submucosae. The CD44s and CD44v6 expression rates in gastric carcinomas with a lymph node metastasis showed a statistically significant difference compared to those without a lymph node metastasis (p<0.001 and p<0.01, respectively). CD44s and CD44v6 were also expressed in the normal basal cells around gastric carcinomas. CONCLUSIONS: The CD44s and CD44v6 expression showed a significant relationship with gastric carcinogenesis, toward an aggressive biologic behavior.
Carcinogenesis ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Population Characteristics ; Serous Membrane

Omental leiomyosarcomas are rare intra-abdominal tumors. This report describes a case of primary leiomyosarcoma of the greater omentum. A 76-year-old female complained of palpable abdominal mass which was revealed to be a primary omental tumor by means of UGI, small bowel series, abdominal ultrasonography, and computed tomography. Upon laparotomy, no metastatic focus was found and a part of tumor was found adhered to gastric serosa. Total omentectomy including the mass was performed. Histological examinations of the tumor confirmed a diagnosis of leiomyosarcoma. At 36 months postoperatively, there is no sign of tumor recurrence or metastasis.
Aged ; Diagnosis ; Female ; Humans ; Laparotomy ; Leiomyosarcoma* ; Neoplasm Metastasis ; Omentum ; Recurrence ; Serous Membrane ; Ultrasonography

In gastric cancer, the only potentially curative treatment is surgery that attempts to achieve curative (R0) resection. However, despite the use of curative resection, a recurrence develops in a high percentage of patients, especially in cases of serosa and/or lymph node involvement. As a strategy to improve the survival of the patients with resectable advanced gastric cancer, neoadjuvant chemotherapy has been evaluated in several phase II trials and a few phase III trials. The results of these trials have confirmed the feasibility and safety of this approach with no apparent increase in surgical complications. Recently, the findings of a large phase III randomized trial (MAGIC trial) have indicated that compared to the use of surgery alone, perioperative chemotherapy, using both a neoadjuvant and adjuvant strategy, decreased the number of T and N stage cancers and improved survival. The results of another recent phase III trial (FNLCC 94012/FFCD 9703) also showed that compared to the use of surgery alone, perioperative chemotherapy improved the R0 resection rate and survival. In both trials, the improved outcomes may be attributed to the use of neoadjuvant chemotherapy because of poor compliance with adjuvant chemotherapy. These results cannot be directly translated to clinical practice in Korea due to differences in surgical techniques and outcomes. However, the findings of a few small phase II and III trials performed in patients with locally advanced gastric cancer in Korea have also suggested that neoadjuvant chemotherapy would result in the improvement of the R0 resection rate and down-staging of the disease. More effective chemotherapy regimens are needed in future large randomized trials to determine the subset of patients that will benefit from neoadjuvant chemotherapy and to determine the extent of benefit.
Chemotherapy, Adjuvant ; Compliance ; Humans ; Korea ; Lymph Nodes ; Recurrence ; Serous Membrane ; Stomach ; Stomach Neoplasms